Appropriate Administrator, please verify this section.
Student:
Student Assistant:
Appropriate Administrator, please complete this section, print the form, sign it, and return it to the Information
Technology Help Desk for processing.
Security request type:
My signature below certifies that the above named employee requires access to data in a computer-based information system
because such data is relevant and necessary in the ordinary course of performing his/her job duties. I understand my obligation
to provide training to this employee to ensure that he/she understands the state and federal laws and University policies that
govern access to and use of information contained in employee, applicant, and student records including data accessible through
computer-based information systems.
Appropriate Administrator Signature Date
CMS Security (to be completed by PeopleSoft ITS Security Administrators)
Comments:
PS Security:
* This form will be kept on file.
The employee identified above is approved and certified to receive access to PeopleSoft.
Signature:
Signature:
Signature:
Signature:
Signature:
Signature:
No
Yes
No
Yes
Employee Information (to be completed by employee)
Appropriate Administrator Information
Step 1.
Step 2.
Add/Update Access Security: (If known, list the name of an existing or prior PeopleSoft user that the individual requesting
security should mirror. If a modification is necessary, please include details.)
HCM (Human Capital Management) CS (Campus Solutions) FIN (Finance)
New User Modify User
Delete User
Yes
No
Step 3.
Authorizations (please obtain signatures before submitting to ITS)
Employee has a completed CMS Access and Compliance form on file with HR.
Tracie Matthews (Director, Financial Aid)
Jeffery Savage (Director, Admissions and Recruitment)
Missy Klep (Dir., Budget, Purchasing and Support Services)
Emily Deakin (Controller)
Damon Blue (University Registrar)
Eddie Washington (AVP, Human Resources Programs)
PeopleSoft System Access Request Form
Signature:
Name (First M. Last) :
Email Address :
Position/Job Function :
Department :
PS Empl ID :
Work Phone # :
Rev. 8/17/2007
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Name :
Modification Details :
Role(s):
Special Instructions:
