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Instructions for Completing Access to Electronic Resources Authorization Form

The Access to Electronic Resources form must be submitted and approved in order for access to be granted. All information and the appropriate A or B signature block on the form must be filled out in its entirety before it will be considered for approval. Further details for completing each section of the form are listed below.

Account Holder and Requestor Information:

Please complete all information for both the Account Holder and Requestor.


Please include why the account holder is not available to grant the access requested, including a description as to why the access is needed. This section cannot be left blank. Specify any known, active or pending grievances or litigation actions that might be associated with the employee.

Resources Requested to Access:

Specify the date range for how long access is needed to the resource. Select the appropriate checkbox for the resource, specify which access is needed, and supply additional information as necessary. Be sure to include who should be receiving the access to that resource as well as their account ID or username.

Required Authorization Signatures:

The necessary approval section is determined by the account holder's role at the University; student or employee.

Section A is for Student account access only and should be signed by the requestor.

Section B for access to Employee accounts (includes consultants, guest, and volunteer) is signed by the requestor, who must also obtain the Division/Department Head or Dean's signature. Please note, the Division/Department Head or Dean must be at least two supervisory levels above the account holder and cannot be the same person who is requesting access.

After proper signatures have been obtained the form should be submitted to the Information Security Office:

Columbia, Hospital, Extension and UM System business units: Submit the completed request form to the Information Security Office by sending email to isam@missouri.edu or fax form to 573-882-5116.

Kansas City, St. Louis and MS&T business units; send to your Information Security Officer.

Once the request has been received by the Information Security Officer final approval signatures are obtained. This process may take an extended period of time depending on the circumstances.

Reviewed February 27, 2016.