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Wireless Access Request Form v1.1: Provide A Business Justification For

This document is a wireless access request form containing the following information: 1) The form requests information about the remote user such as their name, network ID, job title, and employment status. 2) It requires the user to provide justification for needing wireless access such as what customer accounts and applications they need to access and what company resources they will use. 3) The user must confirm whether they will access customer/client or confidential credit card data and describe the equipment that will be used for wireless access. 4) By signing the form, the user agrees to abide by the company's wireless communication policy and understands that all wireless access attempts are logged and monitored. Approval from multiple managers is

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Marc Marino
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300 views2 pages

Wireless Access Request Form v1.1: Provide A Business Justification For

This document is a wireless access request form containing the following information: 1) The form requests information about the remote user such as their name, network ID, job title, and employment status. 2) It requires the user to provide justification for needing wireless access such as what customer accounts and applications they need to access and what company resources they will use. 3) The user must confirm whether they will access customer/client or confidential credit card data and describe the equipment that will be used for wireless access. 4) By signing the form, the user agrees to abide by the company's wireless communication policy and understands that all wireless access attempts are logged and monitored. Approval from multiple managers is

Uploaded by

Marc Marino
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Tracking # 001

Wireless Access Request Form v1.1


Section I: Remote User information
Wireless User Information
Reports to Name: Date
Site: Select site
Remote access requested for:
Name: Network ID: HR Job Title

Employment Status Full Time Alorica Employee Contractor or Temp Worker


Section II: Justification for remote access

The ability to connect through a wireless network connection is provided to authorized employees, only. Approval is
based on the requestor’s job title, job duties, application/access requirements, and justified usage. Connection are
authorized using the Alorica provided software installed only on company owned equipment only. Alorica management
and or security will review the request and determine if the employee is eligible for wireless access.

Check the applicable boxes, and provide a justification and descriptions of your wireless usage.

Provide a business justification for wireless access?


     

What customer account(s) do you support?

Other:      
What customer applications will you be accessing?      
Please provide a full list.

Select the company resources that you plan to use over a wireless connection.
Email (Outlook)
Instant Messaging (Spark)
SharePoint Data
WFM
Client Applications
Payroll
HR data
Shared data on server
Other:      
Will you be accessing Customer/Client Data? Yes No
Will you be accessing Confidential/Credit Card data? Yes No

Notes to requestor:
If an existing desktop or laptop is to be used the system unit must be cleared of all prior data and ensured that it meets
Alorica software configuration standards. All equipment inventory information and serial numbers must be provided. All
equipment MUST be returned upon termination of employment or when no longer required.

Note: Remote users are NOT permitted to store any sensitive company/customer data (e.g. Payroll, SSN, Credit Card
data, or confidential information) on the systems local drives or any other mobile storage media device. You are
required to save sensitive company/customer data on a network drive. It is your responsibility to ensure the network
drive used will be included in the enterprise backup schedule.

543088447.doc_AloricaVer1.1 9/19/2021 Page 1 of 2


Tracking # 003

Wireless Access Request Form v1.0


Section III: Remote User Information
Remote access requested for:
Name: Network ID HR Job Title
Section IV: Equipment usage
What company owned equipment will be utilized for wireless access?
Reissue current Laptop from site inventory Order new Laptop.
Mfg/Model       PR#      
Serial Number       Copy of PR must be attached.
___________________________
Operating System:      
Current service pack installed:       System Mfg/Model       Serial Number      
Built in wireless Yes No Monitor Mfg/Model       Serial Number      
Is the laptop hard drive encrypted: Yes No Operating System:      
Current service pack installed:      
Built in wireless Yes No
Is the laptop hard drive encrypted: Yes No

Section V: Requestors Acceptance of policy


User acceptance:
All attempts to access the Alorica network (system) through wireless connections are logged to ensure their use is
authorized for management of the system, to facilitate protection against unauthorized access, and to verify
security procedures, survivability and operational security. Misuse of and all unauthorized attempts to access this
system may be subject to civil and/or criminal action. All information contained on or sent within this system is
considered to be proprietary property of the Alorica Companies. There is no individual expectation of privacy. By
logging on to the system you consent to monitoring for this purpose. All connections must be made using Alorica
owned and maintained equipment only.

The requestor further consents to abide by the company Wireless Communications Policy (available on file). Your
signature below is your acceptance to this policy and user acceptance statement above.

Requestor: Enter users name here      

Section V: Signatures/Approval

Actual signatures are required.


Please sign then email scanned copy with signatures.

Title/Name Signature Date


Manager: Enter Manager name here      
Site Director: Enter Site Ditectors name here      
Information Security Department: Enter      
Information Security Approvcer's name here

Note: Director Of Information Security approval is mandatory for any contactors, third parties, or non Alorica associates.

543088447.doc_AloricaVer1.1 9/19/2021 Page 2 of 2

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