City of Stamford Technology Department

Network Access Form - New City Employees

Are you requesting an account for someone who will work for the Stamford Public Schools? Please, do NOT use this form. Use the form specifically designed for the school system to avoid delays in getting your account created. Thank you!

To avoid confusion and prevent delays in processing your request, please use this form ONLY for BRAND NEW employees. DO NOT USE THIS FORM if someone just needs some changes to their current account; instead please use the account modification form and tell us what has changed (new location, new job title, new network needs, etc.).

First Name:

Last Name:

Employee ID (if known):

City Department

Job Title

Check the box that best describes the employee's job function.

City Employee

Seasonal / Temp

Consultant

Intern

Elected or Appointed Official

Expected Last Day of Work (please note, that if no date is given, the account will expire in 6 months).

Expected Last Day of Work (please note, that if no date is given, the account will expire in 6 months).

Board or Commission for this Official

Please give the business phone number for the new employee:

Is this employee replacing another person who is leaving this department?

Yes

Please indicate the outgoing employee:

In the box below please indicate what Network Resources (Folders) the employee will need. It is important to be accurate as this is what determines what the employee may or may not access on the network. If you are not sure, you may indicate the name of someone who has the same rights that the new employee will have. If the employee is replacing someone, then indicate if the employee will have the same rights as that outgoing person.

If your new user will need HTE, please fill out this form to request an HTE account. https://stamfordct.seamlessdocs.com/f/HTERequest

Comments?:

Please note that you cannot request or approve your own account. This must be done by an authorized individual in your location who will sign below. Unauthorized forms will not be processed.

Approver's Phone Number

Approver e-Signature

First Name

Last Name

Choose how to sign

Draw Type

All Network Access forms require a signature. You can create a legally binding e-Signature here