Tennessee Technological University
Advancement Informaon Systems and Resources Request Form
Access to Advancement Informaon Systems and Resources systems is a privilege. Individuals with a work-
related need for access to the informaon contained in these systems may be granted such privilege based on a
qualied request submied. By requesng access and subming a signed request form, all users are agreeing
to abide by all Tennessee Tech policies specically 801—Informaon Technology Acceptable Use, 802—Access
Control and 851—Informaon Security Roles and Responsibilies.
First Name
Last Name
Phone Number Campus Box
T Number
Please describe the purpose for desiring access:
As the applicant’s supervisor, I recommend approval of the above applicant for access to the requested Advancement Infor-
maon System and/or Resource. I agree to nofy the Execuve Director of University Advancement of any change in this
individual’s employment status or job responsibilies that would warrant a change in access privileges.
Supervisor Signature Date
Applicant Signature Date
To be completed by University Advancement
Acons taken/by whom/date: