Download Database Account/Privileges Request Form

Please deliver completed form to:
ITIS Database Administration
Young Hall (YONG)
Database Account/Privileges Request Form
Infrastructure Services
Database Administration
Account Type (check all that apply):
 Individual
 Shared
 Oracle
 SQL Server (check one of the following for SQL Server)
 SQL Server Authentication
 Windows Authentication
 Windows Group
 New
 Existing
Account Information:
Career Account Login:
Purpose:
IP Address:
First Name:
Middle Initial:
Last Name:
E-Mail:
Campus Phone:
Project Team:
Department:
Signature:
Requester Information: (if different than account information above)
First Name:
Last Name:
E-Mail:
Campus Phone:
System Owner Authorization:
Name:
Signature:
Data Steward Authorization:
Name:
Signature:
Complete access privileges on next page
Database Account/Privileges Request Form, Continued
Requested Privilege Domain: (check all that apply)
 Production
 Training
 QA
 Development

Other (Specify)
________________
Requested Access / Change to Load Directory:
 No. (We don’t use LOAD directory)
 Yes.
 Deny Existing Access
Requested Access / Change:
 Delete Account
 Remove Indicated Access
 Add/change access
Privilege Level
Database
Name
Object(s)
Owner
Read
Write
Please do not write in this section
For use by ITIS Database Administration
Completed by:
Date:
Read
Only
Execut
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