Change of Employee Status Form

To inform RawTec of a change in employee status within your organization, please complete this form as thoroughly as possible and submit.  Thank you.

Company Name:*
Submitter's Name:*
Submitter's E-mail:*

Employee Information

Employee's Name: (important- please double check spelling)*
Status Change:*
Effective Date:*
Employee viewed as security threat:
Is this employee taking over someone else's position? Who?:
New Department:
New Location:
New Title:
New Email:
New Supervisor:
Contact Phone Number (with extension):
Cell Phone Number:

Copy Settings From Existing Employee (or provide the detailed access information below)

Copy settings from this existing employee name:

Detailed Access Information:

Primary PC (list secondary machines if applicable) separate with commas:
Provide a Password:
Member of Security Group:
Network Drive Access(ie. L:, etc.):
Access to any other company resources that may not be tied to security groups(separate with commas):
Member of Email Distribution Groups:
Sharepoint Access and Privileges:
Remote Access Required:
Computer Assignment: does the employee need local admin privileges on their primary pc or will they use multiple pc's (local admin vs standard user)
List of software needed for that employee (Line of Business) separate with commas:
Additional Comments:
Word Verification: