Fillable CSUF Information Security Office (California State University, Fullerton)

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CSUF Information Security Office (California State University, Fullerton)

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CSU Information Security Requirements mandate restricted access for off-campus Internet host to on-campus resources.
Internet access to on-campus servers will be blocked for all network protocols with the exception of HTTP (80) and HTTPS
(443). All other network protocols require prior approval through this authorization process.
(1) Requester's Name (Must be an MPP)
(2) Responsible Department
(3) Technical Contact Name
(4) Server IP
(5) Primary Server Purpose
(6) Protected Data Present ? See the CSU Information Security Data Classification Standards:
http://www.fullerton.edu/it/_resources/pdfs/8065_FINAL_DRAFT_Data_Classification_CW_V4.pdf
Yes
No
No
Yes
a. Is any "Level 1" protected data stored or transferred by/on this server?
b. Is any "Level 2" protected data stored or transferred by/on this server?
(7) Specific Additional Internet Access to On-Campus Server Request:
a. Specify which network Ports/services are needed open. Include whether TCP/UDP protocol, port number, and
application that uses the port(s):
b. Rationale
for needing this port open AND Impact of Not Doing:
Request for Internet Host Access to On-Campus Resources
(8) In order to meet campus secur
ity compliance, I understand IT has my authority to do periodic
vulnerability scans to my server, and I will remediate any vulnerabilities within 30 days or this access
will be blocked.
(9) Required Approvals:
a. Requester (MPP):
b. Division Vice President:
Date:
Please send the completed form to the Information Security Office (iso@fullerton.edu) for final approval
Date:
Information Security Officer:
I Understand
Date:
CSUF Information Security Office
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CSUF Information Security Office (California State University, Fullerton)

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Completed 22 July 2020

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