Title: Security System Access Application
Author: Property & Facilities
Last saved by: Melissa Petrie
Company: UQ - Property and Facilities

Property and Facilities Division
	Form
	18/07/17

Security System Access Application			        PF238
This application form is to be used by UQ personnel and Contactors (“Applicant”) to request for access to The University of Queensland (“UQ”)’s Security System(s).  Please refer to the Application Process page [insert link] BEFORE completing this form.
SECTION A – APPLICANT’S DETAILS
Title (please select):  	☐ Mr 	☐ Mrs 	☐ Miss 	☐ Ms 	☐ Dr 	☐ Prof
First Name | | Last Name |
Position Title |
UQ Username |
Organisational Unit Name |
Phone (Full) | | Email |
SECTION B – REQUIRED SYSTEM ACCESS

Please select the System you require access to: 
☐ Access Control System – SiPass
☐ CCTV System – FLIR or Davis (Circle required system)
☐ Intruder Alarm and Duress System – Inner Range Concept
☐ Alarm Monitoring System – CAMS9 (Contractors only)
☐ Overlay System – DV15 (Contractors only)
Reason for Access:

SECTION C – COMPUTER DETAILS
Please provide the following information of the computer that the selected System(s) will be used on :
Computer Name |
IP Address |
SECTION D – APPLICANT’S DECLARATION AND SIGNATURE

I declare that no one other than myself will use the System login credentials (i.e. Username, Password, PIN, etc.) resulting from this application and that these credentials will not be revealed to any other person. I understand that damage or misuse of data or information accessed via these credentials on the requested System (including passing information on to unauthorised people) may result in revocation of access to the system and possible punitive action.
By signing this form, I agree to abide by these responsibilities.
Applicants Signature:

SECTION E – AUTHORISATION BY APPLICANT’S SUPERIOR

If Applicant is UQ personnel, this section must be completed by the Applicant’s Head of Organisational Unit (NOT direct Supervisor).  If Applicant is Contractor, this section must be completed by the Contractor’s Company Manager.

I authorise this request and understand that it is my responsibility to advise the Security Technical Office of any change in the applicant’s position or responsibility (including termination) which affects the appropriateness of the System login and access privileges granted.

First Name | | Last Name |
Position |
Signature | | Date |
	Security System Access Application			        PF238
APPLICATION PROCESS
The process for requesting access to UQ’s Security System(s) is as follows:
1.	Complete all fields of this application form (PF238), including the signature of:

a.	The Applicant (the person who will be using the System and will take SOLE responsibility for issues of conduct pertaining to the System login credential that will be granted, i.e. the person must keep their Username, Password or PIN private; and

b.	The Applicant’s Head of Organisational Unit (NOT direct Supervisor) (for UQ personnel) or Company Manager (for Contractors).

Each Applicant is to complete one form. Providing incomplete or incorrect information will result in delays with processing your application and / or your application being rejected.

2.	UQ personnel: log an Archibus work request with the completed application form attached. In Archibus select the Problem Type “SECURITY SYSTEM CUSTODIAN APP” to ensure that the request is automatically assigned to the Security Technical Office.

Contractors only: send an email to SecurityTechOffice@uq.edu.au with the completed application form attached.

3.	Once the application has been approved by the Security Section, the Security Technical Office will send the Applicant their System login credentials and any other relevant information and / or documentation.

Processing of the application may take up to 10 working days from the date of request.
Please be aware that the Property & Facilities Division (“P&F”) is the owner of the Security Systems and the Systems are administered by P&F’s Security Technical Office. The Security Technical Office provides the support services to assist the Applicants in the use of the Systems. The Security Technical Office may, at any time, also audit and review the access privileges given to the Applicant and the Applicant’s use of the system, and may revoke access as directed by the Manager Security.
If you have any further queries about this form or the application process please contact the Security Technical Office on SecurityTechOffice@uq.edu.au or (07) 334 68834.

Security Office Use Only:
Authorising Officer: 				
Position: 					
Signature: 				
Date: