Student Trends Analysis and Reporting (STAR) Account Request Information Technology Services Form ITS-6825 Rev -- 9-18-14 Page 1 of 3 Purpose This form grants access to current student data that is available through a digital dashboard to authorized administrators who wish to identify, analyze and report on student trends. These reports provide a means of measuring impact toward student success. Authorized users are reminded that the student data compiled for these reports may contain Levels 1 and 2 confidential information and, as such, must be securely accessed, used, stored and destroyed. Instructions This request is for new accounts only. To request a modification to an existing account, please use ITS-6826 Student Trends Analysis and Reporting (STAR) Modification Request. 1. 2. 3. 4. 5. 6. 7. Type or neatly print all required General Information. Failure to fill out this form completely and accurately may result in a delay in processing your request. Sign and date after reading the "Acknowledgment of Confidentiality and Appropriate Use of Account” statement. Only requests with original signatures will be processed. All others (i.e., faxed, photocopy or electronic) will NOT be accepted. Forward the request to the appropriate administrators for approval. Forward the request to the University Registrar (data steward) for approval and assignment of dashboards. Forward the request to Information Technology Services. When your student trends analysis and reporting user ID is ready, you will be notified to visit the ITS Help Desk to retrieve your account and password information. Your One Card is required for identification when you pick up your account information. Student trends analysis and reporting training is available online at http://www.calstatela.edu/trainme. General Information Tracking Number: Name: Names Also Known As (AKA) (if applicable): Title Employee ID: (CSULA One Card ID#) College/Division: Department/Business Unit: Office Location: Office Extension: Department Extension: myCSULA Identity User ID: Email address: Current Position (check one): Full-time Faculty Part-time Faculty Full-time Staff Part-time Staff MPP Other Are you also enrolled as a student? Yes No Yes No Justification for Access Describe the specific job duties and tasks that require your legitimate access to the STAR application. Dept. Chair New Student Reporting Account Request Information Technology Services Form ITS-6825 Rev -- 9-18-14 Page 2 of 3 Acknowledgment of Confidentiality and Appropriate Use of Account: Under the Family Educational Rights and Privacy Act (FERPA); CSU Executive Orders and policies; Cal State L.A. Administrative Procedures, standards and guidelines; and applicable federal and state laws and regulations, those California State University, Los Angeles employees with access to any and all institutional administrative systems (e.g., Student Administration, Financials, Human Resource Management, and Contributor Relations systems) are entrusted with the maintenance of the security and confidentiality of institutional records and information. Authorized employees (referred to as system users in this document) are expected to adhere to the following rules: 1. System user agrees to the use of the account granted under this application for work associated with the programs of the California State University, Los Angeles and/or the California State University system. 2. Unauthorized use or access to institutional system records and information is prohibited. 3. System user is prohibited from exhibiting or divulging the contents of any record or report to any person except in the execution of normal duties and responsibilities. 4. System user is prohibited from using any data accessed by this account for fund raising; gender and/or ethnicity-based recruiting/selections; or other barred activities. 5. System user is prohibited from personally benefiting or allowing others to benefit from knowledge of any confidential information gained by virtue of work assignments. 6. System user may not directly or indirectly cause the inclusion of any false, inaccurate, or misleading entries into any records or reports. 7. No official record or report, whether paper, electronic, or a copy thereof may be removed from the office where it is maintained, except in the performance of system user’s duties. 8. System user agrees to maintain account and password security and will not disclose account and passwords to anyone. 9. System user agrees to maintain adequate security precautions for access, use, retention and disposal of student data, and, after accessing student data, agrees to exit the system before leaving a computer unattended. 10. No one is to aid or act in conspiracy with another to violate any item under this Acknowledgement of Confidentiality and Appropriate Use Section. 11. System user understands that the violation of federal and state laws and regulations related to security precautions for the protection of confidential information may be a crime and may be subject to appropriate legal action. I have read and understand the Acknowledgment of Confidentiality and Appropriate Use of Account section of this document. I will maintain the security and confidentiality of any institutional records and information entrusted to me as stated above. I understand that if there is reason to believe there is a violation of University computer security or FERPA, my account and account contents may become subject to monitoring and examination by authorized personnel. I also understand that any violation of these security precautions may be a crime and may lead to appropriate legal action and/or criminal prosecution. Printed Name: _____________________________________________________ Applicant Signature: Date: Administrator Approvals* Department Chair/Manager* Date: Dean/Division Head* * FERPA certificate must be submitted with this application Date: Executive Director, UAS ** Date: By signing this request, administrative approvers affirm that the job duties described in Justification for Access meet the requirements for granting access to the Student Trends Analysis and Reporting system. It is the department chair/manager's responsibility to initiate a Request for Modification to Student Trends Analysis and Reporting Account if this applicant's job responsibilities change. Any one of the access approvers can revoke this account at any time by submitting a Request for Modification to Student Trends Analysis and Reporting Account. ** The Executive Director of UAS must approve all applications for UAS employees only. New Student Reporting Account Request Information Technology Services Form ITS-6825 Rev -- 9-18-14 Page 3 of 3 Dashboard Assignment(s) and Approval The following dashboard(s) have been assigned and approved for this applicant based on the Justification for Access described above. Dashboard Assignment(s) Admissions Degrees Enrollment Financial Aid Student Financials Student Success Other: ___________________________________________________________ ___________________________________________________________ Registrar (Data Steward) Date: Information Technology Services Approvals Based on review of the Administrator and Registrar Approval signatures, I grant permission to proceed with this request. Director, IT Security and Compliance Date Vice President, Information Technology Services and Chief Technology Officer Date