Stockton University
Banner Account Request Form
Version 4.1 - 08/15/2019
Office of Information Security
information.security@stockton.edu
STOCKTON UNIVERSITY
101 VERA KING FARRIS DRIVE
GALLOWAY, NJ 08205-9441
BANNER ACCOUNT
REQUEST FORM
If you have any questions about this form:
Please call x4779 or email information.security@stockton.edu
STILL HAVE
QUESTIONS?
Banner Custodian Authorization
SECTION 3
Mary Hughes
Jo-Anna Inferrara
Joe LoSasso
Cindy Crager(Finance)
(HR)
(Student)
(Alumni)
(Financial Aid)
(Bursar)
Nancy Martorano
Thomas Roth
Date
Date
Date
Date
Date
Date
(Banner General)Walead Abdrabouh
Date
MANAGERS ARE TO SUBMIT
FORM DIRECTLY TO
INB MODULE CUSTODIANS
TO BE AUTHORIZED
AUTHORIZATION IS
REQUIRED BEFORE ANY
CHANGES ARE APPLIED BY
INFORMATION SECURITY
Request Details
Type of Request
Clone Access From User?
SECTION 2
To be completed by
Manager/Supervisor
Mary.Hughes@stockton.edu
Joanna.Inferrara@stockton.edu
Joe.LoSasso@stockton.edu
Cynthia.Crager@stockton.eduFinance
HR
Student
Alumni
Financial Aid
Banner General
Nancy.Martorano@stockton.edu
Walead.Abdrabouh@stockton.edu
Screens Required
(if not cloning access
from another user)
Yes, Username:
Manager Signature Date
Change AccountCreate New Account Remove Account
SELECT ALL
RELEVANT
MODULES
Budget Unit Manager
Department
Bursar Thomas.Roth@stockton.edu
Argos Access (if checked) Argos Reports Required
BDM Access (if checked) BDM Access Required
Last Name
First Name
Z-Number
Personal Identification and Information
I have read, understand, and will abide by the rules set forth in the Information Technology Services Standards. www.stockton.edu/acceptable-use
SECTION 1b
To be completed by
the Requestor
Staff Faculty Adjunct TES
Username
Z
Student Worker Affiliate
Requestor Signature Date
SECTION 1a
Use of this Form
Form Information
STEP 1 Applicant/User completes Section 1b and gives the form to their Unit Manager.
STEP 2 Unit Manager completes Section 2 and sends the form to the appropriate Banner Custodian for authorization.
Please see the Banner Screen/Form reference table on the reverse of this form for reference. If it is still unclear
as to which custodians are required, please contact information.security@stockton.edu for assistance.
STEP 3 Banner Custodians submit the form to Information Security for the requested actions to be taken.
