University of Tasmania

University of Tasmania
Request for Access to University Services
( For University roles other than student or staff member )

URL Index
New Role
Expiry Review
Persons who are not employees of the University of Tasmania may be provided with a University account and access to associated services, required to support a School or Section or associated Organisation, where approved by the appropriate authorised person.

Please Note: There is currently a five (5) working day turn-around on new NUMA form processing. We are sorry for any inconvenience that this causes.

Tasks for the Applicant:
  • Fill out your personal details, the services requested, the department involved and the email address of the coordinator for the department. These details are in blocks 1, 2, 3, and 4 respectively.
  • You may populate your personal details with data from the Identity Management Database by pressing the 'Fill Form from my LOGIN' button if you used authenticated access to invoke this form.
  • Provide as many of your names as possible. If the detail provided is insufficient to distinguish you from existing entries in the Identity Management Database your request will be delayed while the ambiguity is resolved.
  • Ensure you provide the coordinator with a good copy of photo identification, for example a Driver's Licence. Your name and birthdate need to be legible. (Scan and email or provide a paper version)
  • Ensure you provide the coordinator with a signed copy of the ICT Services and Facilities Use Agreement . (Scan and email or provide a paper version)
  • Ensure you have set the email address of the coordinator correctly. If you don't nobody will know your application exists!
  • Submit the form by pressing the 'Send to Coordinator' button

Please CHECK the tasks ABOVE BEFORE you PRESS a button




Access to University services is requested:
for the person detailed below,
Name
Title Preferred Name
Family Name *
First Name *
Second Name Third Name
Birth Details
Gender *
Date of Birth *
Birth Family Name
Home Address
Street Address Suburb Postcode
City/Region District/State/Province Country
Contact Details
Home Telephone Mobile Telephone Business Telephone
Prior UTAS Ids
Student Id Staff Id Non Member Id

to have the access detailed below,
Service Required
Service Provided *
Period for which access is requested
From: *
To: *
Location
Work location *

in order to support the University School/Section or Organisation below.
Name
School/Section/Organisation *


Work Flow participants nominated to process this request.
Email Addresses
Nominate staff for these roles
Applicant If applicant has a contact address please enter here.
Coordinator Who will liase with service recipient and forward documentation to ITR? e.g. Secretary
Authorising Officer Who will authorise school/section/organisational responsibility? i.e. Head, Director, Manager, or CEO etc .
Registrar Patrick.Carnuccio@utas.edu.au Normally Patrick.Carnuccio@utas.edu.au
Communicator Who will communicate the service access key/password details to the recipient? e.g. School/Section Secretary

Form 1511107875.3665 Activity Log
Role Notes Button Author Date
Applicant nobody 2017/11/20 03:11:15


 

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