UTEP ID Number Application
Office of Undergraduate Admissions and Recruitment
I understand that this UTEP ID Number is assigned to me at the request of the Department Head
to be used only in connection with my assigned duties as an employee, student/visitor of UTEP
and may be inactivated without notice upon the request of this administrator. I understand and
accept the following terms and conditions:
<>I am aware that my UTEP ID Number is directly linked to my personal information
including social security and am responsible for its secure handling.
<>I am aware misuse of my granted access may lead to the immediate suspension of
my privileges.
Last Name: _____________________ First Name: __________________________
Date of Birth: ___/____/_____
Title: ________________________
Social Security Number: __ __ __-__ __-__ __ __ __
Extension: ____________
Email Address: _____________________________
Authorized Department requesting assignment: _________________________
Reason for needing UTEP ID Number: ___________________________________
____________________________________________________________
Access description:
Building name: _________________________________________
Hours needed: ______________Days needed: ________________
Start Date: ________________ End Date: ___________________
Parking gates:
Yes________
No__________
_____________________________________________________________________________________
Department Head Section: I authorize a UTEP ID Number to be assigned to the above person. I
understand it is my responsibility to inform the Office of Undergraduate Admissions and Recruitment
when there is a change in the applicant’s appointment status.
Department Head Signature: __________________________________ Date:___________
Department Head Name (Please Print): __________________________________
Please hand-deliver to Admissions and Recruitment in ASB 102
due to the sensitivity of the information