:مقرلا ...
:خيراتلا / /
14 ـه
:تاقفرملا ...
ةيدوعسلا ةيبرعلا ةكلمملا ميلعتلا ةرازو فوجلا ةعماج
ةينقتلا عيراشملاو تامولعملا ةينقتل ةماعلا ةرادلإا
Internet Access Request Form
Access Request Number: _________________ Date: _____________________
Employee # Name:
Department / Section:
Position:
User ID:
Telephone #:
Email ID:
Request Details
# Sites / URLs / Service Justification
End date:
Start date:
Duration
End time:
Start time:
Date:
Signature:
:مقرلا ...
:خيراتلا / /
14 ـه
:تاقفرملا ...
ةيدوعسلا ةيبرعلا ةكلمملا ميلعتلا ةرازو فوجلا ةعماج
ةينقتلا عيراشملاو تامولعملا ةينقتل ةماعلا ةرادلإا
Approvals Department Head / Manager
1. I confirm that the access request is justified and in line with the assigned responsibilities.
2. I understand that these access rights will not expose the organization to undue risk.
Comments:
Date:
Signature:
Yes No IT Network Head Comments:
Date:
Signature:
Yes No IT Security Comments:
Date:
Signature:
Yes No IT Network Head Comments:
Date:
Signature:
Yes No
:مقرلا ...
:خيراتلا / /
14 ـه
:تاقفرملا ...
ةيدوعسلا ةيبرعلا ةكلمملا ميلعتلا ةرازو فوجلا ةعماج
ةينقتلا عيراشملاو تامولعملا ةينقتل ةماعلا ةرادلإا
Actions taken by Network Administrator Sites / URLs / Service allowed:
Other Actions:
Administrator name:
Date:
Signature:
