HRD2 - Revised 7/11/03, 9/16/15
City of Northampton
Report of Personnel Action – HRD2
For Information Technology Purposes
EMPLOYEE NAME: _________________________________ DEPARTMENT: ___________________________
Position/Job Title: ___________________________________
Adding Service if adding service please state who is being replaced____________________________________
Removing Service
Date of Service to be Added or Terminated: __________________________________________________________
Phone Service Phone Number _________________________
Computer Hardware:
- size __________
Standard size is 20”
- Networked Printer
- Desktop Printer
Scanner
Other
(explain below)
Software/User Accounts:
Northamptonma.gov Website Access:
For a description of each level click here (must be logged into website to see)
Please indicate the main email distribution groups the employee should be added to or removed from:
Financial Management Team
City Website
GeoTMS
Other (explain below)
Depending on the selections made above IT may schedule training sessions prior to activating a new user.
An email must be sent to Emergency Dispatch to add or remove an employee to the Employee Emergency Alert
Notification Group.
EXPLANATION/DETAIL, IF NEEDED:
AUTHORIZATIONS (as required):
_________________________________ Date: _________ ______________________________________Date:_____________
Department Head IT Director
