EMPLOYEE SYSTEM ACCESS REQUEST

EMPLOYEE SYSTEM ACCESS REQUEST

New Hires / Re-Hires / Terminations
REQUEST TYPE*
EFFECTIVE DATE

MonthDayYear
Date
HIRING MANAGER*
HIRING MANAGERS EMAIL ADDRESS*
example@example.com
STATION*
DEPARTMENT
Submit Request To:*
EMPLOYEE INFORMATION
EMPLOYEE NAME

First NameMiddle NameLast Name
EMPLOYEE TYPE
POSITION/TITLE
MOBILE PHONE NUMBER
REQUESTED EMAIL ADDRESS
(First Initial Last Name at Station Domain -- jsmith@station.com)
DESK LOCATION
(If applicable, name of employee being replaced)
COMPUTER
If applicable, name of employee being replaced
DESK PHONE
If applicable, Enter Extension number
SELECT SYSTEMS/SOFTWARE ACCESS NEEDED
IT SYSTEMS

Network/ADM365/EmailTeamsKnowBe4
FINANCE

Business CentralSolverADPBank Access
NEWS OPERATIONS

OctopusRayos (WordPress)Field 59Social News DeskAdobe Apps (specify below)
SALES/TRAFFIC

WideOrbit TrafficWideOrbit Media SalesShareBuildersEfficioMonarch (Matrix)Digital AdOps (GAM)
ADOBE APPS
OTHER SOFTWARE REQUESTS
OTHER SECURITY/ACCESS REQUESTS (i.e. Distribution List Access, Shared Mailboxes, SharePoint Sites etc.)
Should be Empty:

SELECT SYSTEMS/SOFTWARE ACCESS NEEDED