Saginaw Valley State University

Saginaw Valley State University

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Technology Access Policy

Special Access Request

* Denotes a Required Field

Requestor Username

* Name:

* Requestor's email: (must be @svsu.edu)

Reason / Program

* Reason for Request (including affiliated program):

Previous Access

* Did the individual for whom access is being requested ever have an SVSU email account?

Yes No

Duration of Access

* Duration of Access Requested:

Start Date:	(date format: 05/08/2008)
End Date:

Type of Access Requested

Type of Access:

* VSpace & Email:	Yes No
* Network Access & Web Space:	Yes No (select "yes" if on-campus access to any service is required.)
* Cardinal Direct:	Yes No
* Colleague:	Yes No (If yes, please also complete and submit the User Access Request Form)

OPTIONAL

Print Balance Allotment for microcomputer lab printing: (# of pages)

Special Access for Whom Access is Requested for:

* First Name:

Middle Initial:

* Last Name:

* Last 4 Digits of SSN:

* Birth Date:

(e.g. 05/08/1977)

* Phone Number:

(e.g. 989-964-4000)

OPTIONAL
SVSU ID Number:
SVSU User Name:

Alternate Contact Information The individual listed in item 6 above, will be contacted at their phone number and provided access instructions unless an alternate method of contact is listed below:

Alternate Contact Name:
Alternate Contact Phone:

Processing of requests normally takes 2 - 4 weeks to complete.

* Enter the text above before clicking submit.

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