External Username/ID Card/Library Access Request, Service application forms, Information Technology Services, University of Otago, New Zealand

You can use this form to request a University username in order to access IT services and obtain a University ID card for anyone who is not either an enrolled student or who has an employment agreement (including Honorary staff) with the University.

Please read the University Username and ID Card Guidelines and Information (.pdf, 140KB) before you start.

Note: access to resources and other IT services (e.g. email, Blackboard, Library, etc.) must be requested separately.

Allow 5 working days for your request to be completed.

See the University Username and Password webpage for further information about University usernames.

Fields marked with an * are required.

Applicant Details

Title
First Name*
Middle Name(s)
Surname*
Known Name
Date of Birth* This must be correct for identification purposes.
Address*
Alternate Address
Mobile* Only required if the phone field is empty.
Phone* Only required if the mobile field is empty.
Email* This must not be a University of Otago email address.
Campus*
Company name (if you are a contractor)

Application Type

Type*
Explanation

University Department Details

Department*
ID Card required?* This is required for Library Borrowing and Door Access.
Termination Date for Username/ID Card* You can select up to 2 years from the current date.
Student Services (Unipol, Student Health) ?*

Declaration

Yes, I have read the University Username Guidelines and Information (.pdf, 484KB) 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 unless the fields are pre-populated. 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*

Human Check

Please complete the below to prove you are human

External Username/ID Card Access Request