Valparaiso University
Office of Information Technology

Request for On-Line Access to University Data Base

Name: _______________________________

Department: ___________________

Date: ______ Phone: ____________


Check the Office from which you are requesting access to information:

____ Admissions Office

 

     Authorization Signature _____________________________ Date: ______

____ Finance Office

 

     Authorization Signature _____________________________ Date: ______

____ Financial Aid Office

 

     Authorization Signature _____________________________ Date: ______

____ Human Resources Office

 

     Authorization Signature _____________________________ Date: ______

____ Institutional Advancement Office

 

     Authorization Signature _____________________________ Date: ______

____ Registrar’s Office

 

     Authorization Signature _____________________________ Date: ______

The departmental authorizer will specify the security class via an e-mail to the help desk.

Return form to switchboard, Kretzmann Hall, after requested authorizations have been signed.

 

Your signature: ______________________________

Copy: Employee; Human Resources

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