BROWN COUNTY TECHNOLOGY SERVICES (BCTS) *DO NOT PRINT*

SYSTEM ACCESS FORM – NEW USER

Supervisor Instructions:

  1. Use this form for system access for anew user in your department or work unit.
  2. Fill out the form completely, ensuring the correct spelling of the user’s name. If you are unsure of the meaning of any part of this form or need assistance filling it out,please call the Help Desk at 448-4030. Missing or incorrect information will delay processing!
  3. Type your name in the SupervisorSignature section and fill in the date (do not hand sign the document). The act of the supervisor forwarding this form from his/heremail account is the equivalent of an electronic signature.
  4. Email this form to (Do not print it out and mail it)

An employee’s supervisor is legally responsible for authorizing the adding, changing and removal of rights to all accessed information, regardless of who enables the access. This includes access to systems that are controlled by the supervisor’s department.

After Human Resources processes the new user, they will sign and forward the form to Technology Services.

BCTS requires 6 business days upon receipt of this form (minimum) to complete the request.

To be entered by Technology Services: Date Received in TS:

*REQUIRED AUTHORIZATIONS*

HR Authorized eSignature:Date:

Typing your name here and emailing the form is equivalent to a signature

Supervisor eSignature: Date:

Typing your name here and emailing the form is equivalent to a signature

Effective Date: (usually the user’s first day in your department/work unit)

*USER INFORMATION*Please ensure correct spelling! Errors will cause delays.

User Type:

☐Regular Employee ☐Paid Limited Term Employee ☐ Vendor/Volunteer/Contractor/etc.(non-employee)

Last Name: First Name: Middle Initial:

Employee ID Number (if employee): Office Phone:

Department: Job Title:

Unit/Division: Building:

Floor: Office/Rm/Cube: PC Name: (ex: “BC-TS-010”)
Found on white tag or dbl click “SystemInfo” on desktop

Vendor/company name: Login: ☐ Individual ☐Shared

Supervisor: Email: Phone:

*BROWN COUNTY EMAIL ACCESS*

☐Outlook email or ☐Internet email only (OWA)

☐Shared email Mailbox - User needsaccess to shared Mailbox(es):

☐User will control calendar forexisting resources (room, vehicle, etc.). Resource Name:

☐Forward Brown County email to State email address of:

* Drive Mappings Required *U, V, & W drives will be set up automatically. Please specify other drives required.

Describe any additional shared drives this user may need. To find this info, go to a PC of a user with similar access, click on

the folder icon on the tray at the bottom of the screen and copy that information here.

Example:

*APPLICATION ACCESS*

Note: •Skype, Chrome, and DropBox are not recommended or compliant with State Open Records laws.

•$ indicates a license must be purchased and will be charged to your department.

Some applications are standard, such as: Microsoft Word/Excel/Access/IE/PowerPoint, Firefox, MoveIT-Secure FTP, and Adobe Reader

☐ $Adobe Pro☐$Microsoft Visio☐

☐$Dragon Naturally Speaking☐ Milestone☐

☐Host on Demand☐VPN requires authorization form☐

☐ Industry Weapon☐ WebEx☐

☐ $Laserfiche☐ Internet Website Maintenance☐

☐ Logos☐Intranet Website Maintenance☐

☐ $Microsoft Project☐☐

Notes:

Important! If access is needed for Department applications that are not managed by the TS Department, please contact the application administrator for that application. Examples include: Kronos, OMS, RMS, Avatar, eWISACWIS, CARES, KIDSetc.

*AS/400 ACCESS*

(Please provide detailed access information or screen print/s)

Add Access Add Access

BCLAND – Treasurer☐BCGEN – Sheriff☐

BCLAND – PALS☐BCGEN – Finance ☐

BCLAND – Municipality☐BCGEN – Health☐

BCLAND – Assessor☐

BCGEN – Human Services☐BCGEN –☐

Other Notes:

For TS Use Only

Page 1 of 3 Updated September, 2017