ZIM_PSN_Vertragskündigung

ZIM - Zentrum für Informationstechnologie und Medienmanagement

All fields marked with a star (*) are required and must be filled out.

Universität Potsdam
Zentrum für Informationstechnologie und Medienmanagemnt (ZIM)
Am Neuen Palais 10

14469 Potsdam

Termination

of the contract for access to the student network of the University of Potsdam

Surname, First name*

Matriculation number

E-Mail*

I would like to terminate my contract for the following network connection

Street, house number*

Residential unit, room*

with effect from*

Potsdam,

Signature of the student*