Cancer Studies and Molecular Medicine
Application for an Associate ITS account registration
IT accounts are provided automatically for students and staff of the University. Associate accounts
provide a means of granting access to University IT systems to individuals who do are not in these
categories. Each account costs the University licencing fees and support time so it is necessary to
record the reasons why this department is requesting an account. This form should be completed (in
Microsoft Word) and forwarded to the Department’s IT contact (Jon Naylor – nay@leicester.ac.uk)
from the UoL email account of the individual staff member who is making the request.
Required Information
Why is the account required? (Please mark one slot)
Associate will be collaborating on research work within this Department
Associate holds a UoL Honorary or Emeritus contract until (please give date)
Associate is carrying out paid casual work within the department
Associate is an academic visitor carrying out research work within UoL
Other (please attach description of desired of role of associate)
Please provide the following information about the type of access required.
How long will the account be required (maximum 1 year between renewals)?
Please indicate the approximate time (hours/week) the associate will be spending
on University related work.
By default the account will be limited to external access to University systems. If
internal access is required please indicate this here.
Please indicate where any internal access is to be given and if possible which PC(s)
are to be used.
Athens access is not normally appropriate for associate accounts if you wish the
University to pay for such access please request that here.
Personal Information required from Associate
Full Name with preferred title (Dr, Mr, Ms)
Home Address (with Post Code)
Private Phone number (landline or mobile)
Date of Birth
Any previous UoL ITS username