Banner Access Request Form by nsr11162


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Student Information Security Application: Banner Access Request Form
Please provide Banner access to the following individual:

Name (Last name, First name)                                              UIN                                Net ID                          Ofc Phone

Job Title                                                               Dept.                              Employment Status (Employee, Extra Help, etc)

                                                                         Reason for
Supervisor's Name                                                        Request

                                                Access is terminated
Employment End Date, if applicable              when employment ends.

      Academic History                                                                            Recruiting and Admissions
      Academic History Query                                                                      Prospect Query
      Academic Standing Maintenance EOT                                                           Basic Admissions Query
      General Learner and Registration                                                            Admissions Query
                                                                                                  Admissions Rating Maintenance
      General Learner and Registration Query
                                                                                                  Departmental Checklist Summary Maintenance
      Registration Permission Override Maintenance
      Attribute Maintenance                                                                       Schedule
      Hold Maintenance                                                                            Schedule Query
      Assign Adviser to Student                                                                   Schedule Maintenance (UIUC)
      Designate Adviser                                                                           Faculty Assignment
      College Academic Standing Override/Max Hour Update
      College Curriculum Change                                                                   Student Access - HR User
                                                                                                  Registration Query - HR
      General Person
      General Person Query                                                                        DARS
      Restricted Access - General Person Query                                                   DARS Access (UIUC DARS/DARwin)
      Pending Degree List
                                                                                                 Banner screen
      Maintain Pending Degree List                                                               instead of a profile.
      Student Access - Finance User                                                              Please list the
      General Person Query - Finance                                                             screen name(s):

  * Descriptions and additional information on desired data can be found online at

   Yes. I have signed an Information Security Compliance Form

   Yes. I have completed FERPA training? If you have not completed FERPA training, please visit the Web site at and print the certificate at the end of the online tutorial as verification
   of completion. The FERPA certificate will be attached and submitted with this completed request form.

Account Owner's Signature                                        Date                         Unit Head or Designee Signature                                   Date

 College of Education Authorization Usage Only

Approval                                                         Date                         Completed                                                         Date

                                                                | 217.333.2800 | 1310 S. 6th St., Champaign, IL 61820

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