FRESNO COUNTY OFFICE OF EDUCATION DISTRICT FINANCIAL SERVICES DOCUMENT PORTAL ACCOUNT REQUEST FORM
Larry L. Powell Superintendent
The following information will be used to provide or revoke access for users of the Document Portal web site. A completed form must be filled out for each user. Please return completed forms to FCOE, Info. Systems & Technology, 1111 Van Ness, Fresno, CA 93721 or FAX to (559) 497-3707. Type of Access: Work Location: [ ] New User [ ] District Office [ ] Delete User [ ] School Site:______________________________________ Dept:____________________________ E-mail:___________________________
District Name:______________________________________ Employee Name:____________________________________
Employee Position:_______________________________________________________________________ User Logon Name:__________________________ User Password:____________________________
Person Completing the Form (Print):____________________________________________________ Person Completing the Form (E-mail):___________________________________________________
WARNING I certify that the requested Login and Password are for the employee indicated above and are to be used solely by them to carry out their assigned responsibilities. The Login and Password shall be held in strictest confidence by the employee and shall not be shared by the employee with others. I understand that failure to comply with this policy may result in the loss of access for the individual(s) and the possible assessment of fees related to the re-establishment of their Login and Password. School Site Administrator
___________________________________________ Print Name Date
_____________________________________________ Signature Date
___________________________________________ Phone
_____________________________________________ E-mail
For FCOE Use Only
[ ] Account Created/Modified By:_______________________
Date:___________________
[ ] User Notified By:__________________________________
Date:___________________
HV 09/06