SOLAR Access Request Form

Application for Access to
SOLAR

I. APPLICANT INFORMATION:
APPLICATION TYPE:	NEW	MODIFY/CHANGE	INACTIVATE		EFFECTIVE DATE:

CSUN ID: (If this application is for a new employee, CSUN ID will be assigned.)		OPERATOR ID:	NAME: (No nicknames, please)
EMAIL: @csun.edu	EXT:	MAIL CODE:	DEPT ID:
DEPT NAME:		JOB CODE:	TITLE:

II. PLEASE SELECT ONE OF THE FOLLOWING EMPLOYEE CATEGORIES:
PERMANENT FACULTY/STAFF
TEMPORARY FACULTY/STAFF	APPOINTMENT END DATE:
STUDENT WORKER	APPOINTMENT END DATE:	SW OPERATOR ID:
AUXILIARIES
NON-CSUN EMPLOYEE

III. PLEASE SELECT ONE OF THE SOLAR MODULES: (Note: Select only ONE module)
A & R	SCHEDULE OF CLASSES	STUDENT ADVISEMENT	FINANCIAL AID	STUDENT FINANCIALS
OTHER (SEE INSTRUCTIONS)

IV. JOB REQUIREMENTS/NEED FOR ACCESS: PROVIDE A BRIEF DESCRIPTION OF YOUR ACCESS NEEDS FOR THE MODULE SELECTED ABOVE: (A & R, Schedule of Classes, Student Advisement, Financial Aid, Student Financials and Other.)

V. SIGNATURE:

MPP ADMINISTRATOR, FINANCIAL MANAGER, SUPERVISOR, EOP DIRECTOR, SOC COORDINATOR, AND DEAN: MY SIGNATURE BELOW CERTIFIES THAT THE ABOVE EMPLOYEE, UNDER MY SUPERVISION, REQUIRES ACCESS TO DATA WITHIN THE SOLAR INFORMATION SYSTEMS BECAUSE SUCH DATA IS RELEVANT AND NECESSARY IN THE ORDINARY COURSE OF PERFORMING HIS/HER JOB DUTIES UNDER THE TITLE AND DEPARTMENT LISTED ABOVE AT CALIFORNIA STATE UNIVERSITY, NORTHRIDGE. I UNDERSTAND IT IS MY OBLIGATION TO ENSURE THAT ADEQUATE TRAINING IS PROVIDED TO THIS EMPLOYEE RELATING TO THE STATE AND FEDERAL LAWS, AND UNIVERSITY POLICIES THAT GOVERN ACCESS TO AND USE OF INFORMATION CONTAINED IN EMPLOYEE, APPLICANT, AND STUDENT RECORDS EITHER IN PAPER OR ELECTRONIC FORMAT.

EMPLOYEE REQUESTING ACCESS: I HAVE READ AND WILL COMPLY WITH ALL PROVISIONS FOR SECURITY AND CONFIDENTIALITY AS STATED IN THE CSUN EMPLOYEE CONFIDENTIALITY STATEMENT AND PREVAILING UNIVERSITY POLICIES. I HAVE RECEIVED OR WILL RECEIVE APPROPRIATE TRAINING PRIOR TO USING THE SYSTEM.

VI. APPROVAL:
______________________________ APPLICANT SIGNATURE	____________ DATE	______________________________ AUTHORIZED SIGNATURE	____________ DATE
CSUN EMPLOYEE CONFIDENTIALITY STATEMENT WILL BE REQUIRED BEFORE ACCESS IS GRANTED.		PLEASE PRINT SUPERVISOR'S NAME:	MAIL CODE: *
* Please see form Instructions for routing information (i.e. Mail Code)

» For Internal Use Only (Do not write in this box) «
ROLE REQUIRES VP SIGNATURE
______________________________________ VICE PRESIDENT SIGNATURE	____________ DATE	______________________________ AUTHORIZED REQUESTOR APPROVAL	____________ DATE
______________________________ SECURITY GATEKEEPER APPROVAL	____________ DATE	______________________________ VERIFICATION OF TRAINING RECEIVED	____________ DATE
______________________________ SECURITY ADMIN APPROVAL	____________ DATE	______________________________ REQUEST COMPLETED BY	____________ DATE

Updated 8/31/2005