R E Q U E S T F O R N E W N O V E L L / E M A I L
A N D B A N N E R U S E R I D
I n f o r m a t i o n Te c h n o l o g y D e p a r t m e n t
Request date: I.T. Department FAX #: x6312
c
New employee c Transfer Department Transferring from
*Name:
First Middle Initial Last
*Z#: Position T i t l e :
*Department: Off i c e L o c a t i o n : P h o n e :
*Dept. Head Signature : P h o n e :
*Required fields
Require d f o r B a n n e r a c c e s s : To b e c o m p l e t e d by the employe e ’s manager or depar t m e n t h e a d . P l e a s e c hec k o n e a c c e s s o p t i o n .
Please give this employee the same access as:
or
Nam e of emp lo y ee wi th ex i st ing Ba nn er acc es s Ban ner us er na me B ann er se cur ity c l as s
I u n d e r s t a n d t h a t t h e a c c e s s I a m r e q u e s t i n g m a y c o n t a i n i n f o r m a t i o n t h a t i s p r o t e c t e d b y
t h e F a m i l y E d u c a t i o n R i g h t s a n d P r i v a c y A c t . ( F E R P A ) . I a l s o u n d e r s t a n d t h a t d i s c l o s u r e t o
u n a u t h o r i z e d p a r t i e s i s a v i o l a t i o n o f F E R P A . W h e n a c c e s s i n g t h e B a n n e r s y s t e m , I m u s t
o n l y a c c e s s i n f o r m a t i o n n e e d e d t o c o m p l e t e m y a s s i g n e d t a s k . T h i s i n f o r m a t i o n m a y o n l y
b e c o m m u n i c a t e d t o a u t h o r i z e d p a r t i e s i n a c c o r d a n c e w i t h t h e p r o v i s i o n s o f F E R P A .
I a g r e e t o m a i n t a i n t h e c o n f i d e n t i a l i t y o f m y p a s s w o r d a n d t o u s e m y a c c e s s t o O R M
i n f o r m a t i o n f o r a u t h o r i z e d p u r p o s e s o n l y .
Name: D a t e :
P lea se pr i nt
Signature :
For I.T. D e p t . U s e :
Novell Login: Banner User ID:
Email Addre s s :
Password f o r N o v e l l / G roup/W i s e a n d B a n n e r ( i f requested) will be:
Pidm: Completed by I.T. :
,
REV 10/07
