VPN Access Request Form
Per T&I Business Practice BP.03.004 Business Practice for Telecommuting Computer Use, any
employee who telecommutes and requires VPN access to Channel Islands T&I resources
(including information assets), must use University owned and managed equipment in order to
protect the integrity of campus information assets and the university network.
Contact Information
VPN Requestor
Supervisor/Dept. Chair
Name:
Department:
Title:
Office Phone:
E-Mail Address:
Duration of VPN Access (Approval is granted for a period of no longer than 1 year per request)
Start Date
End Date
Resources Required
Resource Description
Access Required (Y/N)
User Network Drive (H:/ Drive)
Key Server (for University Issued Computers Only)
Remote Access to University Servers
(please list fully qualified server path - ie. \\crate.csuci.edu\groupshares\...)
Other Services:
Form 02-002 (Original Issuance) VP for T&I/Information Security Revision 02/2017
VPN Access Request Form
Computer Identification
Computer Name
Asset Tag or
Serial Nbr.
Model OS
Signature of User Date
Supervi
sor/Department Chair Date
FOR T&C INF
RASTRUCTURE USE ONLY
Date
Technician Name
Form 02-002 (Original Issuance) VP for T&I/Information Security Revision 02/2017
VPN Access Request Form
Instructions
Complete this form to the best of your ability, and submit it to the T&I Help Desk for assignment,
approval, and processing. Incomplete forms will result in delays. If you have questions about this form,
please contact the Manager, User Services or the T&I Help Desk for consultation.
I
f you are a contractor: The signature of the contracting Channel Islands MPP is required to process this
form. In order to access VPN at Channel Islands, a Dolphin Name and Dolphin ID are required.
You must also complete a Telecommuter Information Security Review and Approval Form
before your VPN access may be granted.
Access to and storage of Level 1 or Level 2 data from off-campus requires written justification from your
supervisor and written approval of the Information Security Officer and VP for Technology &
Innovation. A definition of Level 1 and 2 data may be found in University Policy IT.01.002 available at
http://policy.csuci.edu/.
VPN access is
no longer required to use the full functionality of H: drives and Outlook from off-campus.
For access to these services, use Dolphin Files and OWA through myCI.
VPN access
is required for the remote use of:
Group Shares (G: drives)
Key Server (for University issued computers only)
Certain other business systems that do not have other means of remote access
When you use the Channel Islands VPN, your computer is using the University’s network infrastructure
for all traffic. As such, the VPN is for official use only. Unauthorized or inappropriate use of the VPN is
equivalent to unauthorized or inappropriate use of the University’s network.
Consult T&I Business Practice BP.03.004, available at www.csuci.edu/ti/policy.htm, for further details
about authorized and appropriate uses of remote access and for additional referenced forms.
Consult University Policy IT.01.002, available at http://policy.csuci.edu, for definitions of Level 1
and Level 2 data.
Form 02-002 (Original Issuance) VP for T&I/Information Security Revision 02/2017
Contact the T&I Helpdesk to install the current VPN client software (if needed) once your request
has been approved.