REQUEST FOR B.O.S.S. PIN NUMBER & CAMPUS WIDE ID
Part 1: Instructions and Useful Information
1. Fill out all pertinent information on Request for BOSS Pin Number and CWID
2. Sign and date request.
3. Scan and email to firstname.lastname@example.org
Part 2: Personal Information
(Last Name) (First Name) (Middle Name)
(CWID or SS Number) (DOB – MM/DD/YY)
Part 3: Request Information
Please send my B.O.S.S pin number & CWID to the following E-mail address:
I hereby authorize Louisiana Tech University to transmit my B.O.S.S. Pin Number & CWID to
the E-mail indicated above. I understand that by signing this form I am authorizing the release of
my personal information as instructed above.
Student’s Signature: Date:
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