UNIVERSITY OF PITTSBURGH \ FORM INSTRUCTION GUIDE
FORM TITLE: SPECIAL PRIVILEGE APPLICATION
NUMBER: FORM 0032 PITT 1947
PROCEDURE: 10-02-11
ENTER THE FOLLOWING INFORMATION WHERE INDICATED:
1. Applicant's Name (Last, First, Middle Initial - Limit
to 39 Characters)
2. University Personal Reference (PR) Number (PNNNNNNNNN).
Located on the reverse side of the University ID Card
3. Campus Address (Room and Building - See SPI 9)
4. Campus Telephone (Area Code, Telephone Number, and
Extension AAA-NNN-NNNN-XXXXX)
5. Electronic Mail Address (EMail), i.e., your VAX/VMS
Cluster Username
6. School/Responsibility Center
7. Department
8. CAP logname
9. Signature of Applicant
10. Date of signature
11. Indicate System on which special privileges are
requested
12. Indicate special privileges desired
13. Reason for the Request
_
COMPLETED BY CAP PROJECT LEADER AND FAIS ADMINISTRATOR
14. CAP Project Name
15. FAIS Account Number (L-AAAAA-SSS)
16. Printed name of Cap Project Leader
17. University Personal Reference (PR) Number of CAP
Project Leader (See No. 2 above)
18. Campus Telephone (AAA-NNN-NNNN)
19. Signature of CAP Project Leader (required)
20. Date of Signature
21. Printed name of FAIS Administrator
22. University Personal Reference (PR) number of FAIS
Administrator (See No. 2 above)
23. Campus Telephone (AAA-NNN-NNNN)
24. Signature of FAIS Administrator (required)
25. Date of signature
_
FOR COMPUTER ACCOUNTS
26. Approval Signature
27. Date sent to RIDC Park
28. Signature of person confirming
29. Disk Structure
30. Expired Files
31. Date of Confirmation