Faculty, staff and any other authorized users who have computer accounts at Binghamton University are expected to abide by the Binghamton University Computer and Network Usage Policy.

Please fill out this form completely so that we may process your request with a minimum of delay. All requests for access will be forwarded to the appropriate functional lead for approval. Please allow 5 business days for processing.

If you have any questions please contact the ITS Help Desk at 607-777-6420 for assistance.

Name:                    First:	Middle:  Last:
Job Title:
Phone Extention:
BU E-mail address:
Department:
Supervisor:
Supervisor's Email Address:
Supervisor's Extention:

Please check the action to be performed: New Account Modify Account Access Terminate Account

University Affiliation: Faculty Staff Non-BU

Banner Duties (check all that apply): Course Building Student Inquiry Registration Advisor Dars

Have you completed Banner Navigation Training?: Yes No

If yes, enter date of training class (MM/DD/YYYY):


Please give us a brief description of the access needed in Banner and how the information will be used:

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Principles for Protection of Confidential Information
It is the responsibility of all University employees and/or persons with access to University data to respect the highest level of privacy for their colleagues and other members of the University community. All persons with access to the University systems are responsible for compliance with University privacy policies. Also, all persons with access are required to read, understand and abide by these principles.

By submitting this request, I agree to the terms listed above.

To submit your request click on the 'Submit Form' button and to cancel your request click on the 'Clear Form' button.

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Last Revised on 01/07/2008