Account Request Form For Faculty/Staff - DOC by HC12091815472

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									                             Business Objects Account Request Form - Admissions

                                                      Requestor’s Information

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

                                          Start Date

                                  Campus P.O. Box

                                            Eagle ID

                                    Campus Phone

                                        Department

                      Current Google/AD 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:

      Please Return Form to:   Sarah Smith - Admissions -P. O. BOX 8024
      After approval, please   Accounts Management
             return form to:   P. O. BOX 8136
                               FAX – (912) 478-0272

   For Admissions Use Only:                                                                                FOR ITS USE ONLY:
                   Group Assignment
                                                                                                           CASE #: ________________
       ADM Colleges                                          Academic Data Mart
                                                                                                           ADD TO BANNER ROLE
       ADM Eagle Incentive                                   GOML                                          BAN_PSOFT_FINANCE: _______

                                                                                                           PASSWORD: _____________
       ADM Orientation Advisors
                                                                                                           GSBUSOBJECTS-L: ____
       ADM Recruiting
                                                                                                           NOTIFICATION SENT: ________

   Authorization: ___________________________________________ Date: ___________________


   Authorization: ___________________________________________ Date: ___________________                           Revised 8/12

								
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