SonicWall Release Form

Woodstown/Pilesgrove Regional School District
Internet Release/Restrict Form
Please fill out this form in its entirety, print it out, sign it and have your supervisor sign it and return to Technology Office

PART 1 - Personal Information

Staff Member Name:

E-Mail Address:

Building:

Room #:

PART 2 - Fill out either part A or B, but not both!
A) Block or Release a website

http://

B) I Want to Remove the Filtering!

Set up an Override Password * that I can use on any computer:
        (* removes all web filtering until browser is closed. Permanent removal is not possible)

UserName: (use no spaces or capitals)

Password:    (case sensitive)

example: username: joeteacher, Password:   prairieDOG

PART 3 - Explain, briefly, why this action should be taken.

PART 4 - Declaration of Responsibility
I understand that restrictions are in force due to possible questionable content of some websites. I have personally reviewed this website and have deemed it appropriate for the above stated situation. I take responsibility for any repercussions that may occur as a result of the release of this website and/or the temporary removal of restrictions from a specific computer.

PART 5 - Signatures (BOTH signatures required for request to be granted)

_____________________________________
Signature of Employee _____________________________________
Signature of Supervisor