Banner Finance Authorization Request Form

Please complete the top 2 sections of this form and then print the form to obtain necessary signatures.

Return to: Business Office - 3rd Floor Knight Campus

Please provide the following information:

Date:

CCRI ID:

First, MI, Last Name:

Title:

Department:

Campus:

Phone Extension:

E-mail:

Employee Role:

Faculty Staff Student Help Lecturer

Account Type:

New Terminated Change

Required Security Classes:

Entry Level Approval Level

FOPAL information:*

Organization Code(s):

Fund Code(s):

* Contact Kent Gates x1114 with questions

Agreement: I have read, understood, and agree to comply with the CCRI Data Security Policy and the CCRI Policy on the Responsible use of Information Technology, I understand that I am responsible for any computing activity carried out using this account.

Applicant's Signature: _____________________________ Date:_________________

Supervisor's Signature: _____________________________ Date:_________________

Business Office Use Only

User Role: _________________

Access to: Test Production

Data Access Office Signature: _____________________ Date: ______________

IT Dept. Completion Date and Initials: _________________

Last Updated: 12/13/12

Community College of Rhode Island

Banner Finance Authorization Request Form