iValidate Request Form

Complete and submit the following form 2 weeks in advance of event date.

Important Notice: iValidate will ONLY work on the UMW secure network "UMW-AUX", available in or near most campus buildings.  Please check for WiFi availability prior to reserving.

Availability:

Monday through Friday 8:00am to 5:00pm. iPad and readers are reserved on a first come first serve basis and EagleOne will let you know via the email address provided if we cannot fulfill your request.

iValidate Policy:

I understand that:
1. The requesting department assumes responsibility for iPad and iValidate reader.
2. The requesting department may be charged for any damage or loss to iPad or iValidate reader.
3. The requesting department assumes responsibility for any/all users of equipment, including students.
4. NO CHANGES should be made to the iPad software, configuration, settings or applications.
5. iPads will automatically log in to the secured network. Please do not try to change any network connection settings.

1. Contact & Department Information

   Please enter the information for the department/group and the responsible contact individual.
2. Department/Group * Required
3. Department Contact * Required
   First Last
4. Contact Phone * Required
5. Contact Email * Required
6. iValidate Pick Up: * Required
   • I am picking up the equipment
   • I am sending someone to pick up the equipment
7. Individual Collecting Equipment (valid ID required) * Required
   First Last

8. Event Information

   Please enter the event details.
9. Event Name * Required
10. Event Location * Required
11. Event Start Date - must be mm/dd/yyyy format * Required
    MM slash DD slash YYYY
12. Event End Date - must be mm/dd/yyyy format * Required
    MM slash DD slash YYYY
13. Brief Description of Event * Required

14. iValidate Request Information

    Please provide request details.
15. Number of iPads/Readers Needed * Required
    123
16. Pick Up Date - must be mm/dd/yyyy format * Required
    Please provide the iPad and reader pick up date
    MM slash DD slash YYYY
17. Return Date - must be mm/dd/yyyy format * Required
    Please provide the anticipated iPad and reader return date
    MM slash DD slash YYYY
18. Usage Type * Required
    Please Note: Demographics will NOT be available for admission fee or retail sale.
    • Admission (No Charge)/Demographics Capture
    • Admission Fee
    • Retail Sale/Donations
19. Policy Acceptance * Required
    • I have read and understand the iValidate policy and accept the usage terms.
20. Reader Functionality * Required
    One Set PriceMultiple Price Points
21. Additional Information/Special Instructions

22. FOAP Information

    Please provide the department FOAP where collected funds should be transferred.
23. Fund * Required
24. Org * Required
25. Account * Required
26. Program * Required
27. Name
    This field is for validation purposes and should be left unchanged.