SouthwestVirginiaCommunityCollege
RemoteNetworkAccessRequest
Form
Completeandsignthefollowing:
___AddNewUser ____UpdateUser
Name:________________________________________________
(Print)FirstNameMiddleInitialLastName
Office\DivisionName:___________________________________
RemoteaccesstoSWCCNetworkandresources:
TheabovelisteduserhasrequestedremoteaccesstotheSWCCNetwork.
Thisaccesswillrequiretherequestortoinstallthe Palo Alto
GlobalProtect(Virtual PrivateNetwork)Clientontheirremotecomputerand
validatetheirlogonwithSWCCcredentials.Thiswillgranttheuseraccessto
SWCCNetworkfromaremotelocation.
ImmediateSupervisor’sSignature:________________________Date:_____
ForTechnologyServicesUseOnly:
VPNREMOTEACCESSACCOUNT
Createdby:__________________________________________Date:_____