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External Username/ID Card/Library Access

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Use this form to request the creation of an external username for people who are not staff or students of the University of Otago. An external username is required to enable requests for access to other services such as a University ID card, Library resources and IT services.

You will need to read External Username, ID Card and Library Access guidelines and information (.pdf, 56KB) before you start.

Please allow 5 working days for this request to be completed.

Do not use this form to request a username for someone who is an enrolled student or is employed directly by the University. A University username is created automatically for these people.

Please visit the University Username and Password page for further information about usernames.

Fields marked with an * are required.

Applicant Details

Title First Name* Middle Name Surname* Known Name Gender* Select Gender: Female Male

Date of Birth*

Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month: January February March April May June July August September October November December Year: 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905

Address* Alternate Address Phone* Mobile Email* Company name (if you are a contractor) ID Barcode or Username ID Number

Application Type

Type* Please select: Centre for Innovation Staff Clinical Lecturer Staff Contract Staff Emeritus Professor Research Staff Foundation Year - UOFY Staff Language Centre - UOLC Staff Visiting Staff Other Non-OU Staff (please provide an explanation) Language Centre - UOLC Student Foundation Year - UOFY Student Other Non-OU Student (please provide an explanation) Otago Graduate Retired Staff Other (please provide an explanation) Explanation

Department Details

To be completed by the University department sponsoring the applicant.

Department*

ID Card required?*

Yes No

Termination Date for Username/ID Card*

You can only select up to 31/12 of the following year.

Please read Definition of University Staff within the
Guidelines and Information document.

Library Borrowing - The applicant is required to agree to and comply with the University's Library regulations.

Reason for Username/ID card

Building access?*

Yes No

Library Borrowing?*

Yes No

Off-campus Access to Library E-Resources?

E-Resources Dunedin
E-Resources Christchurch
E-Resources Wellington

Access to services (e.g. Blackboard, Email, PIMS, VPN)*

Yes No

Other (please specify)

Declaration

*Yes, I have read the Guidelines and Information document and agree to comply with University policies and guidelines.

Authorisation Details

Your request for an external username must be approved by your Head of Department or delegated authority. Please enter their details below. An email message will be sent to them when you submit this form. Once we receive their response approving your access, we will action this request.

First Name* Surname* Username* Email* Account code*

GL_______7728___ or PL_____________7728___

Submit Request