Role Assignment Request Form

Request Overview

This form is used to request the assignment of a role to a person within the organization.
Each role defines a set of responsibilities and specifies the IT/information assets and permissions associated with it.
By submitting this request, you indicate that the individual requires this role to perform their job duties.
Access will only be granted after approval through the access management workflow.

Requestor Information

Your Name *

Your Email *

Person to be Assigned

Person's Name *

Person's Email *

Home Organization / Department *

Role Assignment Details

Role to be Assigned *

Role Scope *

Requested Start Date *

Requested End Date

Justification Category *

Justification / Purpose *

Information Assets and Permissions Required

Information Asset 1 *

Permissions for Asset 1 *

Information Asset 2

Permissions for Asset 2

Information Asset 3

Permissions for Asset 3