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New Faculty Account
Please fill out the information below. You must submit proof of your UCLA affiliation before your account is approved. If you do not attach proof of your affiliation to this application, please contact the UCLA Community Housing Office at (310)825-4491.
Faculty Information
*Account Type
Department
Department Contact Person
Department Phone (xxx-xxx-xxxx)
Personal Information
*First Name
*Last Name
*Address
 *City
State
Zip
*Country
Unit Number
*Phone Number
Internat'l Phone Ok
Alt. Number
Internat'l Phone Ok
*Email
Fax Number (xxx-xxx-xxxx)
Confidential! - The password must be less than eleven characters!
*Password
*Retype Password
*Hint Question
*Hint Answer
Proof of Affiliation
 
* = Required Field
I have read and agree to the terms and conditions.