New Hire Request - EXTERNAL

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New Hire Request - EXTERNAL USE ONLY, as this is publicly accessible.
***This is also used for vendor access***

Subject

Please enter subject as follows:
New Hire Request - EXTERNAL - USER'S NAME - DATE OF HIRE

First name of person for whom you are requesting access:

Middle Name

Last Name

User's immediate supervisor, or responsible party for this person:

Effective Date? IT will attempt to complete all requests by the requested date

As far as you know, has this person ever been active within Fairfield county technology systems?

Answer with the information you have at the time you're completing this form. This will help IT be on the lookout during account creation.

Is the user transferring to another department?

Which department/organization will the person requiring access work with?

Will the person requiring access be an employee?

Please provide a valid driver's license number *Required for non-county staff*

Driver's license issue date

Driver's license expire date

Please enter user's SSN:

Date of birth - Used to verify if user's record already exists

Is this user a vendor?

If vendor, please provide the organization:

Please choose all options that apply that the user will require:

Computer Login

Door Access Badge

MS Office 365 License

VPN Access

For access purposes, please provide the user's email address:

Will this person's role be considered essential?

Additional language will be added to the badge to indicate such. Relevant to travel during weather emergencies. Questions, contact EMA Director.

Does the person require computer access?

i.e. county computer login, county systems login for Enterprise ERP, county folder access for a business purpose

Is an email account required?

If need, what building(s) does this person require access to?

Standard practice, when it's an employee, is to give access to only their "home" building, where they office each day. Standard practice, when it's an employee, also gives access to admin courthouse mail room and records center side door.

What times should the person be given access?

Are there any special requirements?

If Other, please explain:

Upload Badge Photo

Please be sure glasses are not being worn, no hat, no neck coverings and hair is not covering face in any way

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Other Fields

Your name

Your email address

Verification Code