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My Information
First Name:
Last Name:
PLU ID #:
PLU Phone:
PLU Email:
Confirmation email to:
Department(s):
I authorize the person listed below to act as my designee for:
Request Access
Approve access requests
Designee Information
First Name:
Last Name:
PLU ID #:
PLU Phone:
Department(s):
Need assistance with this form?
Name a DOAR (Designated Office Access Requestor)
Deans and department heads approve access. However, they may name a DOAR to act in their stead. To authorize a designee, complete and submit the form.
