Account Request Form For Faculty/Staff by 2bEj7R5

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									                                      Business Objects Account Request Form

                                                       Requestor’s Information

                                               Name
                                                         Faculty  | Staff  | Casual Labor 
                                       Title/Position

                                          Start Date

                                 Campus P.O. Box

                                            Eagle ID

                                    Campus Phone

                                        Department

                     Current AD/Google Account
                                                         
                       Type of Access Requested           New Account                   Additional Access
I understand that I will be assigned a username and password for my use only and that I will not cause them to be known or used by
another person or persons. I understand that I am solely responsible for the security of the assigned username and password. I will notify
the Georgia Southern Help Center at (912) 478-5429 in the event that this security may have been compromised.

    Requestor Signature:                                                                Date:
                                                                                        Date:
    Approval Signature Dean/Director:
    Print Approval Name
                                                                                        Date
    Dean/Director:

       After approval, please   Accounts Management
             return form to:    P. O. BOX 8136
                                FAX – (912) 478-0272

    For Approver Use Only:                                                                                   FOR ITS USE ONLY:
                   Group Assignment                                      Group Assignment
                                                                                                             CASE #: ________________
       DOS - DEAN OF STUDENTS                                  ITS - HELPDESK
                                                                                                             ADD TO BANNER ROLE
       FAD – FINANCIAL AID                                     PPL – PHYSICAL PLANT                          BAN_PSOFT_FINANCE: _______

                                                                                                             PASSWORD: _____________
       GOML                                                    SAEM – CLEAN ADDRESS
                                                                                                             GSBUSOBJECTS-L: ____
       HRM - ANNUITIES                                         SAEM – REPORT MANAGERS
                                                                                                             NOTIFICATION SENT: ________
       HRM - IPEDS                                             VPAA-COE-UNDERGRAD TEACHER ED

       HRM - PSEmployee DATA                                   VPB - PEOPLESOFT




   Authorization: ___________________________________________ Date: ___________________                           Revised 7/12

								
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