Slate User Access Request

Employee Information

STOP: If you are requesting access to the Graduate Admissions Reader Review as a faculty reviewer or decision maker, please submit the Graduate Slate Access & Application Process Review Form. You may click cancel below to exit this form.

First Name

Last Name

Preferred First Name

Email (UUID@memphis.edu)

Banner ID (ex. U00123456)

Employee Type

Job Title

Department

Enter the name of your Academic Department

Other Department

Requested Access

Campus Population- Select which type(s) of students your position requires you to review or process:

Other Populations (not listed above)

Please briefly explain how you will use Slate in your job function. Access will be granted based on your use case.

Supervisor Information

The supervisor listed must be an Assistant Director or above.

Supervisor Name

Supervisor Title

Supervisor Email

Acknowledgement of Responsibility

Federal requirements mandate the protection of student academic records. FERPA applies to all schools receiving funding from the Department of Education. The University's federally awarded financial aid funding could be revoked for non-compliance.

As an employee of the University of Memphis (or acting as an agent of the University), I am aware that the data and materials to which I may have access are to be treated in a professional and confidential manner. I agree herein, as a consideration of my employment, that I will not disclose or cause to be disclosed any such confidential information gained in the course of my employment at any time. Such information includes, but is not limited to, student records to which I have access.

I certify that I am aware of the University Policy/Procedure, AA3022, “Privacy of Education Records," which covers the confidentiality of student records, the improper release of information, and the improper alteration or destruction of student records. I further understand that I am responsible for reading and complying with all requirements of this procedure.

I understand that it is my responsibility to safeguard the confidentiality of my password to the Administrative Computer System. Access to the Administrative Computer System and to the Banner Student System application system is for my exclusive use in carrying out my responsibilities at the University of Memphis. Access is not to be shared with any other person. Furthermore, information derived from Banner Student System is not to be shared with others except in the course of authorized University business.

I also understand that I may not adjust my own record, a relative’s record, or a co-worker’s record, or enter or delete any data outside the area of my employment responsibility.

I am aware that any breach of the confidentiality of this material or any abuse of my position, including but not limited to alteration of records, destruction of records or other similar acts, may result in disciplinary action or constitute a basis for termination of employment.

I have completed the FERPA Tutorial found on the Employee tab of MyMemphis.

By entering my full legal name below, I certify that I have read and agree to abide by the above statements.

STOP: New users, do not fill out any fields past this point. The completed request form will be sent to the supervisor listed above for their consideration once the form has been submitted.

For Supervisor Use Only

Slate Access Request Approved

Yes

No

I have reviewed the access request above and have approved/declined the request. I have also confirmed that user has successfully completed the FERPA tutorial (Please type full name as signature).

CRM Manager Email