APJ DXC Badge Form

Request Services for APJ DXC Badging

 Please complete all mandatory fields (*).
 Obtain the following documents (if applicable):
o (Required for restricted access): APARS approval from the restricted space owner.
o (For remote workers and sites without badging offices): Provide a digital passport-style photo, a head and shoulder
view with a forward facing orientation, against a medium gray or light colored background with no distractive objects.
 Send this form with any necessary documents to: dxcphilippinesphysecops@dxc.com

DXC Employee Number * Name (Last, First, M.I.) *

11733816 Disonglo, Lyka Maris R.

Approving Manager Name * Approving Manager Email Address *

Rachelle Gale rachelle.gale@dxc.com

Work Site Location * Telephone Number (include country / city code) *

McKinley Road, McKinley Town 639177703485

Center, Fort Bonifacio, Taguig City

Company Name (if Non-DXC) Country *

Philippines

DXC Sponsors Name (if Non-DXC) DXC Sponsor’s Employee email address

Request Access Badge For: * ✘ DXC Employee Non-DXC Employee (CW) DXC Retiree

REQUEST TYPE *

Access Change ✘ New ID Card Replace: Lost/Stolen Change Name Badge Access Renewal Retiree
Additional Access Level (For CW only)

ACCESS REQUIREMENTS

List Sites you need access to * Pin # Issued (4 digits) (only if required)

1
 APJ DXC Badge Form
(For CW: Indicate Site & Floor you are based)*

IPC All Floors

Ship-to Address for Teleworkers or Off-Site Personnel

Access Hours Requested: * Expiration Date

Business Hours (6AM to 7PM M-F)

✘ 24 x 7
Other- Please explain reason for site access:

RESTRICTED AREA ACCESS (Labs/Special Rooms) (If required)

Authorizing Manager Name for Restricted Area List All Restricted Access Areas Needed

ACCEPTANCE

Electronic Signature Name (type name here) * Email *

Lyka Maris R. Disonglo lykamaris.disonglo@dxc.com

✘ I agree to the following: *

 To follow all security access requirements while on DXC property.

 Employee/Contingent Worker Photo IDs, Card Access and Keys must be returned upon termination.
 Contingent Worker has limited access right. It is only on the floor/site where they are based and some vital
Offices such as Clinic, IT, Security Office.
 Sharing Photo IDs and Access Cards is prohibited.
 Report lost or stolen ID, access cards and security keys to Asset Protection immediately.