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Proxy Server Access Request Form


Faculty, staff, students and residents use their MCWCORP/MCW email username and password to log onto the proxy server.

Volunteer clinical faculty, adjunct faculty and emeritus faculty should submit this form even if they have MCW email addresses.


Please review the form before submitting.

MCW Libraries will verify your status with the Office of Faculty Affairs and the appropriate department, and contact you within five to seven business days with your proxy login information.

Questions? Contact MCW Library Systems at 414-955-4290 or syst@mcw.edu between 8 am and 5 pm, or Circulation at 414-955-8300 on evenings and weekends.

 

* = Required Field

First Name *

Last Name  *

Email Address *

Phone Number (w/Area Code)  *

Company/Clinic/Institution    *

Please provide a home or business address, whichever is the best one to reach you:

Street address   *

City * Zip Code  *

If the zip code above is a business, please provide your home zip code:   

Status:*
 Adjunct Faculty
 Emeritus Faculty
 Volunteer Clinical Faculty
 Children's Hospital employee
 Froedtert/Dynacare employee
 Joint Graduate Degree program

Department affiliation:*

Notes (please provide any additional information you feel is necessary to clarify your status):

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Page Updated 07/28/2014