NORTHEAST STATE COMMUNITY COLLEGE
Request for Use of Technology (Computer Account Request)
Network Access and E-mail
Name: Date:
First Name Middle Initial Last Name
Office Location: _____________________ Phone Number: _________________________________
Department Name:
Faculty will require the signature of VP for Student Affairs for access to the Banner Student
Self Service System: (access to FERPA protected data)
VP for Student Affairs: __________________________________________________________
FERPA: The Family Educational Rights and Privacy Act of 1974 restricts access to non-directory student information to college
personnel who have a legitimate educational interest in obtaining access to a student’s grades and test scores. Disclosure of FERPA
protected data to non-college personnel, or college personnel without a legitimate educational interest, is a violation of a student’s
rights. More information may be obtained from the Office of Admissions and Records
The technology resources at Northeast State are defined as telephone, computer software and hardware, video,
copiers, fax, and fax modems. The technology available is for educational purposes and work-related functions,
and any records created become the property of Northeast State. Unauthorized copying, modifying, or use of the
resources is prohibited. The resources are paid for by the college and use of the resources is a privilege and not a
right. Failure to abide by the policies regarding the use of the technology resources will result in disciplinary
action.
I, the undersigned, agree to abide by the policies on technology resources at Northeast State Community
College. Detailed policies and guidelines on the use of technology resources can be found in the school catalog,
on the institution website, and in the Policy and Procedures manual.
Date:
User's Signature
Date:
Supervisor
Date:
System Manager
Accounts expire June 30
th
of each year
Revised – August 9, 2007 NSTCC-3 96-076
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signature
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