Account Authorization Request Form
Complete the form below and click Submit Form. Upon submission, the form will be reviewed and verified. Then the user's account will be created.
* Indicates a required field
Note: This form cannot be processed until the employee's classification has been updated in the Datatel system by the Human Resources Department.
Employee's First Name*: MI: Last Name*:
How would the employee like his/her name displayed in the Global Address List? (ex. John Smith, John David Smith, David Smith, J.D. Smith, John "Scooter" Smith, Jay Smith, etc.)
Employee's School or Division*:
Employee's Wesleyan ID Number*:
Employee's Job Title*:
Employee's Phone Number*:
Building*: Ann Waggoner Fine Arts Bldg Armstrong-Mabee Business Center Art North Baker-Martin House Bookstore Boyd House Brown-Lupton Campus Center Burleson Campus Central Power Plant Dan Waggoner Hall Dan Waggoner Annex Dora Roberts Dining Hall Elizabeth Means Armstrong Hall Ella C. McFadden Science Center Eunice and James L. West Library Glick House Health Science/Nurse Anesthesia Law School - Downtown Campus Law Sone Fine Arts Center Louella Baker Martin Pavilion Maintenance Center/Security Nenetta Burton Carter Building Nicholas Martin Hall Oneal-Sells Administration Bldg Otho C. Armstrong Hall Polytechnic UMC Scene Shop Schollmaier Science and Technology Center Sid W. Richardson Center Stella Russell Hall The Dillow House Wade Hall Wesleyan Village Other Room Number*:
Employment Affiliation*: Full-Time Staff Part-Time Staff Full-Time Faculty Part-Time Faculty** Adjunct Faculty** Temporary Employee** Student Employee**
**Termination Date: mm/dd/yy
Please note: A termination date is required for all employees classified as "part-time faculty," "adjunct faculty," or "temporary employee."
Dean/Supervisor's Name * :
Requested Access:
*In the field below, list all the email accounts, departmental drives, shared folders, group memberships, and network printers to which the identified employee needs access. If email, file, and print services are not required, please type "none" in the field below.
Additional Information:
*Has the identified employee read the University Policy for the Acceptable Use of Information Technology Resources and the Policy for Acceptable Use of Network Resources statements?
Please note: If you indicated "No", the form cannot be processed. The employee is required to review the applicable policies prior to being issued an account. The applicable policies can be found on the Policies and Procedures page of the ICT web site.
*Has it been communicated to the identified employee that failure to adhere to these policies may result in the revocation of all network/computer system rights?
Please note: If you indicated "No", the form cannot be processed. For assistance interpreting these policies, please contact Human Resources or the ICT Help Desk.
Computer Information:
*Is the identified employee assigned a university computer?
If "Yes," please provide the computer's asset tag number:
Please note: The asset tag number is the six digit number found on the white sticker affixed to the computer. This number is issued by Texas Wesleyan and usually begins with "0".
