Fillable Copy Center Authorization

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Copy Center Authorization

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Rev. 09/24/2018
COPY CENTER ON-LINE
USER AUTHORIZATION
Form
This form is used to grant approval to use the Copy Center On-Line Program.
Once you have completed this form and it is signed by your department head,
please fax to 860-832-2522, or scan to Lucy Cannamela, Cannamela@ccsu.edu
or Kia Bryan, Kbryan@ccsu.edu and you will be added to your department’s list
of authorized users to use the Copy Center On-Line Program.
First Name:
Last Name:
CCSU BlueNet
Account Username
Extension:
Department
Building/Room
Approval to use the Copy Center On-Line Program is granted.
___________________________________ _________________
Signature of Department Head or Designee Date Approved
_________________________________________
Printed Name of Department Head or Designee
PLEASE ALLOW UP TO TWO WORKING DAYS FOR ACCESS TO BE GRANTED
Special Note:
To use the Copy Center On-Line Program you must have a CCSU
Blue Net account. Forms to request this account are available on the
Information Technology Services website at http://www.ccsu.edu/it/forms.html
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Copy Center Authorization

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Completed 20 November 2019

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