Request For Flat File Access

ASR Information:

I affirm the data I am requesting will be used in accordance with the
aggreement specified by the steward(s) and I have read and understand
University policies AD-20, "Data Security and Privacy" and AD-23 "Use
of Computerized Institutional Data".

Your UserID@HOST:
(i.e. abc1@psu.edu)
Admin Area:
Phone:
Purpose of Request:
(Specify why access is needed)
Scope of Data:
(Specify population, data values
or selection criteria)
File Identification:
(List the specific file name.
One file per request)
Individual Info:
(Enter name and userid of
individuals to access the file)








* You will receive a copy of the submitted form via email.