Please complete the following form at least one week in advance of the need for changes or additons to computer or phone services for your department.
If you are requesting a phone and/or computer services for a new employee (i.e., one who will not be using the computer/phone formerly used by someone else in your department), we will need more time to provide the resources needed.
NOTE: If this employee will be using a computer that is already in your department, we will need to remotely take over this computer either the afternoon before or the morning of the start date in order to complete the setup.
Accounts are created on Thursday of each week. Forms not received in time, may be processed upon request, but a 24-hour waiting period may apply. Check the Global Address Book for verification that an account has been created. The initial password is set as our standard temporary password. This should be changed immediately by the user. For further assistance, contact the IT Help Desk at 719-8095.

Personal Information

For new and current staff, provide name(s), employee type, title and department. For new staff members, also include home address, city, state, zip and phone information for Jenzabar CX (CARS) system. Home contact information for current staff should be provided if it has changed from what is currently in the system.

Legal name:
Name used if not same as legal:
Home address:
City, State, Zip:
Home phone:
Employee type:	Adjunct FacultyFull-time FacultyInternStaffTemporaryOther
If other, specify:
Title:
Department:
Location:
Phone number:

Reason for Request

Check all that apply.

Additional employee: New employee
Start date:
Returning employee/student: Previous employee Former student
CARS ID number:
Replacement : Replacement employee
Replacement for whom?:
Former employee has been/is:	reassignedno longer here If not here any more, complete "No longer with university section."
If reassigned, to what department?:
No longer with university: No longer with university
Former employee's account should be:	MaintainedTemporarily disabledPermanently deleted
Date to Disable/Delete:
If temporarily disabled, date to delete:
Location Change: Location Change
Move date:
Current Room #/Location:
Current Phone:
New Room #/Location:
New Phone:
Miscellaneous: Additional resources/services required Title Change Other
If Title Change, new title:
Effective date of change:
If other, specify:
Resources/Services Needed: Check all that apply. Computer Printer Email Phone Voice Mail CARS access CARS web access only (Class lists/web grading)
Additional comments:
Requestor's Name:
Requestor's email address:

Some required answers are missing or incorrect.