MADD User Change Request Form

MADD User Change Request Form

Action to be Taken

Select User Type

Setup New UserUpdate Existing UserTerminate Current UserLeave of Absence for UserContract/Intern/Volunteer

Request Type

CreateExtend End DateDisable

Requester Information

Requester's Name

Requester Email

User's MADD Office

Location

Type of Employee

Select Type of Employee

MADD Office EmployeeHome Office Employee

Employee Phone Number

Employee Extension

User Information

Legal Last Name

Middle Initial

Legal First Name

Preferred First Name

Department

Title

Title

Other Title (maximum 35 characters)

Supervisor

User Needing Update

Preferred Email Address for Employee (if different than First.Last@MADD.org)

End Date: Date of contract/internship/volunteer completion. Note: you will still need to submit a disable request to complete the account removal.

User Updates

Update to Occur

NameTitleDepartment/OfficeSupervisor

Enter New Name

Enter New Title

Other New Title

Enter New Department/Office

Enter OLD Supervisor's Name

Enter NEW Supervisor's Name

MADD Office Address

Office Number and Street Name

Office Suite Number

Office City

Office State

Office Zip Code

Home Office Address

Home Number and Street

Home Suite Number

Home City

Home State

Home Zip

New User: Salesforce and Volunteer Notification Access

Please select the level(s) of access (if any) that the new user will need:

Constituent Management

VIP

Victim Services

Court Monitoring

Volunteer Management

Will this person be receiving notifications of New Volunteer Sign-ups?

YesNo

If yes, for which location(s)

New User: Adaptive Access

Please select the level(s) of access (if any) that the new user will need:

Adaptive

Salary Info Access:

With SalaryWithout Salary

Adaptive Role

Adaptive Location

Location Requesting Access to #1:

Location Requesting Access to #2:

Location Requesting Access to #3:

Location Requesting Access to #4:

Location Requesting Access to #5:

New User: Concur Access

Concur

Please fill out all required fields:

Concur Role

Concur Location

Access Needed

EmailDocusignDonorDriveUKGTeamsBadge (IRVING LOCATION ONLY)Salesforce: Court MonitoringSalesforce: Constituent ManagementSalesforce: Other (Please specify)

EmailSalesforce: Court MonitoringSalesforce: Other

Other Salesforce Access:

User Termination/Disable

User Name for Termination

Email to be Disabled

Forward Terminated User Email to

Extend End Date

Email Address

Supervisor

New End Date

Date of contract/internship/volunteer completion. Note: you will still need to submit a disable

request to complete the account removal.

User Leave of Absence

User Name for LOA

Enable or Disable User

LOA User Email Address To Be Sent To:

Equipment Assigned to User

MADD Computer:

YesNo

Computer Service Tag

Effective Date and Time (Central Time)

Effective Date

Effective Time (Central Time)

Additional Information

Additional Requester Notes

Limit of 250 characters

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Contact Information