Information Systems

NEW EMPLOYEE INFORMATION

Please provide the following information:

Note: Please use official names in the fields below.The official campus directory will display employees' names as they are listed here.

First Name: *

Last Name: *

Department:*
Academic Affairs Administrative Services Bookstore Business Computing & Software Systems Counseling & Career Services CUSP - Center for University Studies and Programs Division of Enrollment Management Education Educational Technology Facility Services Finance & Administration Human Resources Information Systems Interdisciplinary Arts & Sciences Interdisciplinary Arts & Sciences Graduate Office Library Media Center Nursing Office of the Chancellor Ombudsman Public Relations and Communications Quantitative Skills Center Security Slide Library Student Affairs Student Government Teaching and Learning Center Writing Center

Position Title: *

Role: *
Faculty Staff Student Worker - UWB Student Student Worker - Non-UWB Student Temporary Staff Other

If other:

Location - Building: *
UW1 UW2 LB1 LB2 LBA CP1

Room # :*

Office Phone Number: *

(Note: If this person does not have an office phone, please use the departmental office phone number.)

Pre-existing Email Address (Optional):

Internal Mail stop:

Direct Supervisor: *

Supervisor Email Address or Phone Number: *

Assistant (Optional):

NETWORK FILE STORAGE

This account includes a home folder (in \\uwb.edu\Faculty-Staff\Home) on one of our file servers.

Does this person also require access to a departmental share folder?

Yes*
No*

If Yes, check share folder name(s) below:

EMAIL SERVICES

This account includes a UW Bothell Exchange Server mailbox by default.

Do you wish to disable this functionality?

DISTRIBUTION LISTS

Access to distribution lists and public folders requires UW Bothell Exchange Server mailbox.
Please list any Bothell email distribution lists, public folders or departmental email inbox(es) needed below.

UWB Distribution Lists (listname@uwb.edu)

Seattle Distribution Lists (listname@u.washington.edu)

nball@u.washington.edu
nbstaff@u.washington.edu
nbfac@u.washington.edu
nbls@u.washington.edu
nbbus@u.washington.edu
nbbft@u.washington.edu
nbcssf@u.washington.edu
uwbcabinet@u.washington.edu

APPLICATION / DATABASE ACCESS

Does your department use an application or database that requires special security permissions for this person?

Please list:

Will this person need access to edit your departmental website?

Note: This sends a request to establish an account in CMS for this employee.

Yes

REQUESTOR INFORMATION

Full Name:*

Department*

Email address:*

Phone Number:

Additional Notes:

After you have submitted this form, please allow at least one business day for completion of this request (hours are M-F 8am-5pm, except holidays).