Sveucilisni racunski centar                                    _______________
Ulica Josipa Marohnica bb                                     I  Obrazac SA2  I
10000 ZAGREB                                                  I_______________I
Tel.: (01) 51 00 33                                            ______________
E-mail: helpdesk@srce.hr                                      I              I
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                          ZAHTJEV ZA POSEBNE USLUGE

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    titula                     ime                            prezime

Opis posebne usluge koja se trazi: ___________________________________________

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Obrazlozenje zahtjeva: _______________________________________________________

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(Korisnicki racun na koji se zahtjev odnosi: _______________________________ )

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       mjesto i datum                                          potpis


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I   Suglasnost mentora/profesora (za studente):                              I
I   Titula, ime i prezime: _____________________________  Potpis: ___________I
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I Suglasnost CARNet koordinatora (za korisnike s ustanove - clanica CARNeta):I
I   Ime i prezime: _____________________________________  Potpis: ___________I
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I   Sluzbene biljeske: (popunjavaju djelatnici SRCE-a)                       I
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I   Datum zaprimanja: ______________________   Potpis: _____________________ I
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I   Odluka: ________________________________________________________________ I
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I   Novi racun: racunalo: __________ oznaka: __________ lozinka: ___________ I
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I               racunalo: __________ oznaka: __________ lozinka: ___________ I
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I               racunalo: __________ oznaka: __________ lozinka: ___________ I
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I               racunalo: __________ oznaka: __________ lozinka: ___________ I
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I               racunalo: __________ oznaka: __________ lozinka: ___________ I
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I   Administrator/odobrio _____________________________ datum: _____________ I
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I   Napomena: ______________________________________________________________ I
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