Contact InformationRequester Name* First Last NetID*Employee ID (emplid)*Department Name*Phone Number*Email Address* Department Head/Chair (Approver) Email Address* Access RequestWhat are you requesting access to?*Space onlyEquipment onlySpace and EquipmentUR Space Access*Add new userAdd access for existing userRemove access for existing userRemove all access to UR Space for existing userSpace Cost Center Names / NumbersEnter one cost center name or number per line. Click the plus sign (+) at the end of the row to add another line. For help with Space modules, contact System Administrator Jennifer Manning at (585) 275-0942. Equipment Administrator Access*Add new equipment administratorAdd access for existing equipment administratorRemove all access for equipment administratorInclude certification access?*YesNoEquipment Cost Center Names / Numbers*Enter one cost center name or number per line. Click the plus sign (+) at the end of the row to add another line. For help with Equipment modules, contact Plant and Debt Accounting: equipadmin@Finance.Rochester.edu Terms & ConditionsI agree to the following:* The access or use of any University of Rochester data for one's own personal gain or profit, for the personal gain or profit of others, or to satisfy one's own personal curiosity or that of others is EXPRESSLY FORBIDDEN. Also forbidden is the disclosure or distribution of University of Rochester data in any medium, except as required by this employee's job responsibilities. Violations of these guidelines will be dealt with seriously, up to and possibly including employment termination. This iframe contains the logic required to handle Ajax powered Gravity Forms.