User Access Request Form by EDdocs

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									Electronic Proposal Management Application (ePMA)
User Access Form

Effective Date:                            <mm/dd/yyyy>
User Name:                                 <First Name Last Name>
User E-Mail                                <>
User Phone:                                <Telphone + Extension>


User Organization Name (Please click on the field below to activate the drop-down menu):




If user is associated with multiple organizations, please list below according to names in the User
Organization Name drop-down list.




Request Type - check box below:

   New User                Non-Licensed PI User

   Account Change          Account Termination


Type of Account Change - check box(es) below:

   Name         E-Mail              Telephone Number

   Role         Organization




To Be Completed by SAM--Role(s) to be added / roles to be removed. Mark all roles that apply.
Roles: Laboratory (LAB)                          Add          Remove
Principal Investigator
Admin
Budget Reviewer
Technical Reviewer
Top Official
Roles: Site Office (SO)
Admin
Budget Reviewer
Top Official
Roles: Headquarters (HQ)
Admin
Budget Reviewer
Program Manager
Top Official

								
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