New/Existing User Request Form

New/Existing User Request Form

This form must be completed and submitted before any system-wide changes are made.
User's Information:*

First NameLast Name
User's Position/Title: *
User's Effective Start/End Date:*

MonthDayYear
User's Work Location:*
Manager/Requestor's Name:*

First NameLast Name
Manager's Position/Title: *
Office Phone #

Area CodePhone Number
Mobile Phone #

Area CodePhone Number
Department:*
User's Employment Status*

New UserTerminationResignationPosition ChangeReturning User
User's Employment Type*

Full-timePart-timeSeasonal/TempMerchandiserOther
User's Building Access*

Remove all AccessM-F Hours: 6am-7pmM-F Hours: 24/7Weekend AccessKeycard Not Needed24/7 & Data Center
User Equipment Needed /To Be Returned

LaptopApple (Mac)DesktopMobile (iPhone)Shared PCNo Equipment NeededUSB/Cellular CardOther
User's Security Group Access

Remove all AccessBuster AccessBuster LogisticsR: Drive AccessPhoto QC AccessNatural InsightMS Teams AccessGreat PlainsAccountingJobvite AccessInvoice GeneratorInfonet AccessServiceDesk HDRAccounting (Prism)FRX ReportingCase ManagementFor NI Access, Type Employee Number:Other
Buster - Special Access Role

Remove all AccessAccounting ConfigVSA UpdateZip Code CoverResubmit Inv TransEvent SetupDeveloperArchive EventsOrder EntryExtranet CaptureReload Import ZipInfonet AccessItem Setup SecurityInventory ConfigOrder Display ConfigFPRSLI-Covid 19Other
Add or Remove Buster Health Screen App Access*

Add buster health screen access for userRemove buster health screen access for user
Notes/Additional Comments
Should be Empty: