Form Center Module

Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Sign in to Save Progress

Employee Change of IT Access Form

Steps

  1. 1. Step One
  2. 2. Step Two
  3. 3. Employee Technology Needs

  • Step One

    2. Access Change Type

    3. Hire Date or Last day of work

    5. Employee Information

    16. *This will be listed on ID Badge

    17. If you do not have a photo available, we will issue a non-photo ID Badge, or take a photo on your behalf.

    19. Clerk ID Badge Access:

      Please check boxes for any additional access this employee needs
      Please note all Clerk personnel are given access to Independence Courthouse & 1840 Simon Kenton Way

    21. Sheriff ID Badge Access:

      Please note all Sheriff personnel are given access to Independence Courthouse & 1840 Simon Kenton Way

    23. CareHere Lab Pickup

    25. County Attorney - Child Support

    27. (Only for employees needing a new ID Badge)

    28. (Only for employees needing a new ID Badge)

    30. Does this employee need a temporary access badge or keyfob?

      Badges for new Employees at Dispatch or Police may be delayed until we have photograph, birthday, and employee number to add to their ID Badge, since it is also used as an Employee ID. If new employee will need a temporary method to access the building until new badge is ready, click "yes".

    36. Building Access (Keycard/ID Badge)

      What buildings does employee need access to? (Only for new/changed employees)