Access Form : STAR Park : Texas State University

Employee Name: First, Middle Initial, Last *

Employee's Job Title *

Texas State ID Number (AXXXXXXXX)

Net ID number (up to 3 letters, with or without an underscore, ends with numbers; ex. tr13)

Room/Lab numbers for employee's access *

Will this employee be authorized to receive mail in the client mailbox? *

Yes

No

Does the employee need access to hazmat building? *

Yes

No

Does the employee need any keys issued? *

Yes

No

List the room numbers or desks for which the employee will need keys.

Does the employee need a phone? *

Yes

No

Does the employee need Calendar Wiz access to schedule STAR One conference room reservations? *

Yes

No

If yes, provide employee's email address.

Name of person granting authority for access and keys *

Email address for person authorizing access *

Name of person completing this form

Access Form