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Dolphin Student Group Website Request Form

The Dolphin e-mail service, sponsored by Information Systems and Computing (ISC), is a service for officially registered University student groups. In order for your student group to be authorized to have a Dolphin site, you must be sponsored by the Office of Student Life and must have a current organization registration form on file with the Office in 200 Houston Hall. The online registration form is available at

Dolphin User: As a Dolphin Account-holding user of e-mail services, I understand that I will be given password-protected access to the Dolphin time-sharing services for my exclusive use in a manner consistent with my responsibilities as a representative of a registered University student group. I agree to maintain and safeguard the secrecy of my password, so that no others may gain access to my Dolphin account using my password.

Your PennCard ID number is your 16 digit number appearing at the bottom of your PennCard.

Student Organization  :	
Requested Account Name:	
Requestor's Full Name : 
Penncard ID Number    :	
Phone Number          :	
School E-mail Address : 

Address               :

To discourage misuse of this form, what is the product of 25x4: 


Information Systems and Computing
University of Pennsylvania
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