User Information - Information supplied on this form is strictly confidential. Please provide complete information.
This section identifies the person using the computer's resources. Please print.
This request is for (choose one):
a UC Employee _____ a Contractor/Temp (non-UC Employee) _____ a Student _____
This request is to (choose one):
Add a new user _____ Transfer to a new department _____ Delete a user _____
If this is a transfer, from (Dept)______to (Dept) ______
First Name: ______Middle: ______Last: ______
Birth date:______
UCID: ______Telephone: (______) ______- ______x ______
Department: ______Job Title: ______
Mail Location: ______or address: Street: ______
Building/Room: ______City: ______
State: ______ZIP: ______- ______
E-Mail Address (if applicable): ______Current IDs (if applicable): ______
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Department Information – An authorized signature is required.
This section identifies the appropriate approving authority. This person is the sponsor for access by students, affiliates, and any person not considered a direct UC employee. This person is responsible for any and all activity performed on the UC mainframe by non-UC employees.
Department Head / Business Office Manager (please print):
______
Dept. Name: ______Mail Loc.: ______Phone #: ______
Note: It is the responsibility of the undersigned to request the deletion of this account when the account holder is no longer an active member of the university community. Accounts are not to pass from employee to employee. New accounts must be requested for new employees and files can be transferred to new accounts on request.
Authorized Signature: ______Date: _____ / _____ / ______
The User Agreement - Signature of the account user is required before the request can be processed.
In accordance with University Rule 3361:10-17-04: Conduct and Ethics: Use of University Resources:
Members of the Faculty, Administration, Student Body, Volunteer Workers, and Staff are responsible for the appropriate use of University resources. Use of University resources in a manner inconsistent with this rule is a violation subject to disciplinary action.
(B) University Property, Facilities, and Services:
(3) All University computers shall be used solely for authorized academic, instructional, research, administrative or contract purposes. Any unauthorized use of computer resources and/or facilities shall constitute a violation of University policy and will subject the violator to University disciplinary action.
Further, all users of the university's information-technological resources must adhere to the General Policy on the Use of Information Technology. I agree to use this account in accordance with the above:
Signature: ______Date: ______/ ______/ ______
The user of this account shall be responsible for all activities of the account. This account is not transferable to any other individual, nor should the password be given to anyone else.
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Requested Mainframe Services
This section identifies the computer resources or services being requested. If you have questions or problems in completing this form, contact the UCIT Help Desk at 556-4357 or e-mail for assistance.
Applications (for administrative accounts only):Please write the Application-ID of the applications that you wish to access or use in the boxes below. Examples of application are: Financier, UniverSIS, TSO, or regions like SSPR or SSTR
Comments:
For UCIT Use Only
Codes, IDs, and Passwords:Project Number: / ______
UserID (1+3+3): / ______
User Name (6+2): / ______
Initial Password: / ______
Date Form Received: / ___/___/______
/ Comment:
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