IT access request

This form must be completed by the individual requesting access, and it must be approved by the Director of the individual's department before it is submitted to the IT Security Office. The form can be faxed to (405) 325-1633 or emailed to security@ou.edu. Handwritten forms are not accepted.

Employee
Requestor Name:
OU Net ID (4+4):
Phone:
Email:

Department
Name:
Director
Name:
IT SECURITY APPROVAL
Approved By:
REASON FOR REQUEST
ACCESS NEEDED (SYSTEMS)
System 1:			System 2:
System Name:			System Name:
System IP:			System IP:
System Application:			System Application:
Application Port:			Application Port
Additional Instructions:			Additional Instructions:
System 3:			System 4:
System Name:			System Name:
System IP:			System IP:
System Application:			System Application:
Application Port:			Application Port:
Additional Instructions:			Additional Instructions:
If access is needed for additional systems, please complete a second form with additional access information only.

ACCESS NEEDED (NETWORK)
VPN:	Campus (default)	Management	SSL	SSH Bastion Host