• This form alters existing accounts only

• Has the information been changed with Human Resources or the Registrar (students)?* Yes No
• Status:*
  Student Faculty, Staff or Administrator
• Current Name* First Last
• New Name* First Last
• SID Number*
• Job Title and Department
• Email Address*
• Phone Number* - (###) - ### ####
• Building*
  Alumni Recreation Center Carriage House Clare Center Colbeth Hall Cushing Village Townhouses Foy Hall Fr. Ben Kuhn Friary Hennepin Hall Hines Hall Kiernan Hall MacClosky Square Townhouses Maintenance Marcelle Athletic Complex McGuire Hall Morell Science Center Padua Hall Plassman Hall Roger Bacon Ryan Hall St. Francis House St. Thomas More House Sarazan Student Union Serra Hall Siena Hall Social Work House Standish Library 33 Fiddlers
• Room Number
• Effective Date* MM/DD/YYYY
• Other needs or instructions (please specify):

• Please Note: Access to various files and functions require approval of specific individuals. By submitting this form, the position requestor is authorizing ITS to seek approval from the appropriate individuals(s) for file and/or function access when such approval is needed.

• Leave this field blank

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