Internet Filter Request Form

BLOCK / UNBLOCK AN INTERNET WEBSITE (URL)

This form must be completed and submitted to the NPSB Technology Department to request blocking or unblocking of a website address (URL).

 

 

INSTRUCTIONS

 

1. Fill out the following form.

2. Click the "Submit Request" button.

3. Your request will be reviewed by the NPSB Technology Department.

The requestor and school principal will be notified via e-mail when the request is approved or denied.

 

NOTE:

* = REQUIRED FIELD: If left blank your request will NOT be submitted until you complete the * required fields.

 

If there are any errors or messages when you submit your request, the messages will show up in this box.

 

 

 


 

Click here to print this request form.

If you choose to print this request, please do the following when you have completed the form:

Hand deliver, FAX or e-mail the completed request form to Margaret Hall (mhall@nat.k12.la.us) or Adrienne Theus (adrienne@nat.k12.la.us).

FAX (318) 352-4687, if busy FAX (318) 352-8138.

 

Requestor's Information ( * = required field )

 

* First Name:

 

* Last Name:

 

* Job Title:

 

* School:

 

* E-mail:

 

* Date of Request:

 

Details of Request

 

* EXACT URL / Website Address (please include http:// or https://):

 

*URGENT?



 

*ACTION REQUEST



 

*Reason for Request (include curricular/classroom reasons and provide enough detail to justify request)

 

 

*How long does this URL need to be BLOCKED or UNBLOCKED?

Start Date:

End Date:

 

* REQUEST AUTHENTICATION

 

By checking the box above, I agree that:

1. I am authorized to make this request.

2. I have received approval from my supervisor, director and/or school principal to make this request.

 


 

FORM SUBMISSION SECURITY: CAPTCHA Entry

Enter the following characters exactly as they appear in the image.

This tells us that you are a human and not a computer trying to submit harmful code or scripts.

 

CAPTCHA Image
Reload Image


 

 


 

 

OR


If you click "Submit Request" and nothing happens, scroll up to read any error messages that have appeared.
The meesages will alert you to the fields that need attention in order to successfully submit your request.