NC State Student QIC Account Request Form

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This field is for validation purposes and should be left unchanged.

Do you have an existing QIC Account?*

No
Yes

Name*

First Middle Last

Date of Birth*

Unity ID*

Address*

Street Address Address Line 2 City State ZIP Code

Citizenship*

Email*

Employer*

NC State University Affiliation*

Major*

If you answered student, please state your principal investigator(PI) that your are working under, whose work will incorporate the use of quantum computing*

Project requesting access for*

New Project Name

By checking this box you are agreeing to the terms and conditions of use for a QIC Account found here*

Terms and Conditions

I Agree

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