School of Graduate Studies – Security Request Form (Staff)

Form Instructions

All fields marked with an asterisk must be completed.
Date fields are drop-down and in the format of dd/mm/yyyy, (as in 21/07/2013).
Where needed, additional instructions are included directly below a field.

Name *

First

Last

Mac ID *

Employee ID #

Include Employee # if Grade Submission access is required.

McMaster Email Address *

Manager/Supervisor Email Address *

This address will receive a notification of the submitted security request form.

Security Requirements

Mosaic Program Code(s)

(i.e. GINMS, GENMC)

Mosaic Plan Code(s)

(i.e. FINMFIN)

Effective Begin Date *//

End Date (if applicable)//

What security access is required? *

Graduate admissions
Graduate student records
Admin tools
Avenue to Learn (School of Graduate Studies portal)
Other (please specify in "Additional Information" section below)

Select all options that apply

Additional Information *

Brief description of functions access will be required for (Note: if access is to mirror an individual in the same role, please provide the MAC ID in this field).

Update Departmental Contact List and/or SGS Website *

Name