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City of Crestview

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Administrative Services Department
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Community Outreach
Community Redevelopment Agency
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Fire Department

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Police Department
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IT Request Form

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Steps

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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. 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
Last 4 of 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
Other:
Equipment*
1. Desk phone
2. Cell phone
1. Mobile Device
1. Workstation
1. N/A
Phone Options*
Phone Number:
Software
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
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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