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City of Crestview

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Administrative Services Department
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Community Redevelopment Agency
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Public Services
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IT Request Form

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Steps

1. Step One This section is complete This section is incomplete
2. Step Two This section is complete This section is incomplete

Step One

Systems Access Form
Please complete the form in its entirety.
Employee Information
Type*
1. New Hire
2. Change/Add
3. Replacement Card
4. Transfer
Change/Add
Employee Type*
1. General Staff
2. Police
3. Contractor
4. Intern
Start Date
Start Date
Start & End Date
Start & End Date Start Date
—
Start & End Date End Date
Employee First Name *
Employee Middle Inital*
Employee Last Name*
Company Name
Company Email Address
Company Phone #
Date of Birth
Date of Birth
SSN
Sex
Race
Address
Full street address
Personal phone number
Ethnicity
Driver's License Number
DL expiration
DL expiration
Department Information
Position Title*
Department*
Physical Location*
Employee #
Supervisor Name*
Supervisor Phone Number*
Department Head Name*
Transfer From
Requesting
Reasoning
Equipment*
1. Desk phone
2. Cell phone
1. Mobile Device
1. Workstation
1. N/A
Phone Options*
Phone Number:
Desk Phone Display
Display name if different from name above
Software requested
1. ArcGIS
2. AutoCAD
1. CivicClerk
2. CivicHR
1. CivicRec
2. TimeclockPlus Manager
1. N/A
Office 365*
Adobe*
Central Square (H5)*
Identify the username that should be mimicked or N/R if not requesting.
Laserfiche
Printer requested
1. City Hall Admin Hallway
2. Accounts Payable
3. Utility Billing
4. Permitting
5. Community Development Services
1. Public Services- Upstairs
2. Public Services - Downstairs
3. Community Center
4. Twin Hills Gym
1. Fire Station 1
2. Fire Station 2
3. Fire Station 3
4. Police
Shared Email Box
example: permits@cityofcrestview.org
Network Folders
List any an all shared folders the staff member will need. Type in none if not needed.
Example ps-nas/userdata/staff/name
Door Group*
If requesting access to secured areas is needed. HR or Dept Head approval will be required prior to access being granted.
Other:
Supporting Document
Supporting Document
Submitted By*
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