Fillable Administrator-access-request-form Firewall Rule Set Policies-Process-Procedures Guide

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Administrator-access-request-form Firewall Rule Set Policies-Process-Procedures Guide

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S E C U R I T Y P O L I C Y - A D M I N I S T R A T O R R I G H T 1
BSU Administrator Access Request Form
User Information
Last: _______________________ First: __________________ Initial: _____
E-Mail Address: __________________________Phone #: ________________
UserID: __________________________Computer Name: _______________
Location: __________________ How Long Required: ________________
Justification:
Security Statement
I understand that all BSU computer systems, Internet connections and
the associated equipment; software and data are to be used for official
business only AND in conjunction with USM and BSU policies. BSU
policy prohibits any other use of these items. Individuals using BSU
computer systems are subject to having any of their activities
monitored, audited and recorded. Violations of the policy can result in
the loss of my computer privileges and disciplinary action.
I will use only legally authorized copies of copyrighted or licensed
software. I will NOT reproduce, except for backup purposes; any
copyrighted or licensed software and related documentation unless I
have written authorization from the appropriate vendor.
I will select my own passwords and I will NOT share my passwords
with anyone. I will not set my password to automatically be saved by
my system, therefore threatening the security of my password from
unauthorized use.
I will handle sensitive information appropriately. I will not disclose
BSU information to unauthorized personnel. I understand that
sensitive or proprietary information is not to be exchanged or
divulged unless an exchange is necessary for official business.
Please Note: A copy of your job description from Human Resources (HR) has to be attached to this application.
If I become aware of a security breach or incident such as password
sharing or unauthorized use of BSU computers, I will immediately
notify my supervisor, DIT and the Enterprise IT Security Manager.
I have read and will abide by the BSU security policies and rules.
User Sign
ature:
______________________________________________________
Date: ________
Superv
isor Printed Name:
______________________________________________
Approve
Disapprove
Superv
isor Signature:
_________________________________________________
Date: ________
BSU IT Manager Printed Name:
________________________________________
Approve
Disapprove
BSU IT
Manager Signature:
____________________________________________
Date: ________
Reviewed by BSU VP DIT:
___
___________________________
Approve
Disapprove
Reaso
n if Disapproved:
I authorize and assume supervisory responsibility for employee adherence to BSU security policy.
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Administrator-access-request-form Firewall Rule Set Policies-Process-Procedures Guide

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Completed 10 February 2020

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