` UCID Number Request Form

for Associate - Limited Access

(Create, Modify, Inactivate)

Who Should Use This Form?

This form is used for Associate - Limited Access relationship with the University of Calgary, which does not provide
additional system accesses (such as PeopleSoft, library, etc.) but only a UCID and IT account (when required). If you
need more access than this relationship can provide, please visit the Associate relationship website to learn about other
relationship types that may be more appropriate for your needs. The website can be accessed through the “Non-employee
Relationship” section on HR homepage at www.ucalgary.ca/hr.

Please submit completed form to Unicard Office at Dining Centre 18, or through email unicard@ucalgary.ca
Request Detail

Request Type Access Requirements

Request a new UCID UCID

Please proceed with this request
Extend an existing UCID IT Account/Email

Deactivate an existing UCID PeopleSoft

Please consult Integrated Service Centre
Library for appropriate relationship type
Other, please specify

Effective Date End Date

(Up to 2 years)
Do you currently or have you previously had an association with the University of Calgary?

No

Yes, please provide your UCID

Personal Information

First Name Last Name

Date of Birth E-mail Address

Phone Home Address

City/Province Postal Code

University Affiliation

Department Department ID

Name UCID

Email Address Phone

Dept Budget Date

Owner Signature

This information is collected under the authority of the Freedom of Information Protection of Privacy Act. If you have any questions about the collection
or use of this information, please contact the Unicard Office at Unicard@ucalgary.ca or (403) 220-7290.
Last updated: June 28, 2016