Oracle Database Access Request Form
Applicant Information
Dept. Name______________________________
Last Name_______________________________
Social Security #________-_____-________
Campus Phone____________________________
 Dept. Number__________________  Date_____
First Name______________________ MI _____
E-Mail Address___________________________
Campus Address__________________________
Application Information
Please check appropriate responses
Database Access

Type of User

Data Warehouse

Query Only
   (end user)

 People File

Application User

 Banner

Developer



Support Staff
Responsible for granting other access to data currently available to you
Current Hardware/Software Configuration
Computer

Operating System





Memory

Network Connection
 PC Compatible

Macintosh

Windows 3.1

MAC OS

________

Ethernet
 386

68030

WFWG

Version 7.1

Free Disk Space

Appletalk
 486

68040

Windows 95

Version 7.5

_____________
 Pentium

PowerPC

Windows NT
Authorization
Requested Access


 All

 School_____________

Fund_______________
 Dept.______________

Fund Group_______
 Section______
Authorized By:_______________________ Signature:______________________ Date:___________

Existing Client/Server Access                          Data Warehouse                GSPS                  Banner

Please Do Not Write in this Area.
DBA Grant(s)______________________________________
_________________________________________________
 Value Based Security: Yes/No ____________
Grant Use: Yes/No           Grant Grant: Yes/No
Central Campus Applicants - Please fax or mail completed form to Jeff Lincoln
IT&S; - 175 Whitney Ave. - Fax Number 432-5636 - Phone 432-9568
Medical School Applicants - Please fax or mail completed form to Dawn Colonese
School of Medicine - 382 Congress Ave. Fax Number 785-3606 - Phone 737-5211