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IT Access Request Form
    Please email completed form to: itsupport@xxxxxxx.ca

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REQUIRED NETWORK ACCESS:
Drive Letter(s):                                     Example: X:

Path:                          ...
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It Employee Change Request Form

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It Employee Change Request Form

  1. 1. IT Access Request Form Please email completed form to: itsupport@xxxxxxx.ca EMPLOYEE INFORMATION Employee Name: Employee Title: Location: Date Requested: ACCESS CHANGES/DATE New Hire: Effective Date: Department: Temporary Effective Date: End Date: Department: Access : Terminate Effective Date: Access: Suspend Effective Date: End Date: Reason: Access: REQUIRED ACCESS Internet: TELUS: Shaw: E-mail E-mail: Address: Webmail Address: Printer Printer IP Scan to E-mail: Name: Address: Folder Folder Scan to Folder: Name: Location: Printer Printer Print: Name: Location: USB: Networked: Smart Phone: Make: Model: Notes: © 2009 HIT Business Solutions Inc. version 1.0 1
  2. 2. REQUIRED NETWORK ACCESS: Drive Letter(s): Example: X: Path: Example: FinanceAccountsPayable Path: Path: Access: Read Read and Write Notes: AUTHORIZATION Approved by: Signature: Date: Please email completed form to: itsupport@xxxxxxx.ca © 2009 HIT Business Solutions Inc. version 1.0 2

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