Remote Access to Information Systems Authorization Form

Use this form to request remote access to System Administration information resources or for approval to have the software from the Microsoft Education Select Master Agreement installed on your personal computer. 

 

A completed form is required for each employee requesting remote access or to check out the Microsoft CD's. Forward completed forms to the Office of Technology and Information Services. 

 

PART I: (To be completed by employee.)

I am requesting the following remote capabilities or software: (Place an 'X' by the requested services.)

___ E-mail (Specify either ____  Web Access or  ____ Outlook)
___ Access to the System Administration LAN
___ Access to U.T. Austin mainframe systems
___ Access to the World Wide Web
___ Installation of Microsoft Office Software (for business use only)
___ Dreamweaver Software (note: department must purchase license)
___ Other Software Installation - please specify ________________________________

Note:  Software must be removed upon termination of employment at System Administration, or at the end of the term of the Master Agreement.

Provide a brief explanation of your need for accessing U.T. System information resources or for requested software: 
 

 

     

In making this request, I acknowledge the following:

 

The following software is REQUIRED to be on computers connecting to the UT System Administration Network:

    • VPN client software if connection is made via DSL or RoadRunner (software provided by System Administration)
    • Personal firewall if connection is made via DSL or RoadRunner (software provided by System Administration)
    • Current virus protection software installed prior to remote access software installation (software to be provided and maintained by employee, or purchased by System departments)

     

EMPLOYEE SIGNATURE:


DATE:


PRINT NAME:



PART II: (To be completed by the employee's department head.)

Notes: (Please note any restrictions. Also software/hardware, which is to be supplied by the employee or U.T. System.) 
 
     

 

APPROVED

SIGNATURE OF DEPARTMENT HEAD:




DATE:


ACCOUNT NUMBER:


 

(If software/equipment is to be purchased.)

   

 Last updated September4, 2002


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