Cru Technology

1. My request is for: Myself Someone I supervise
2. I need to: Obtain Access Change Access
3. For this application(s):(Select all that apply) Connect & Care (Siebel) PeopleSoft Donor PeopleSoft Financial PeopleSoft HR Email (Active Directory) VPN (Virtual Private Network) Citrix (Terminal Server) Goldmine Lake Hart Desktop Phone

Fill My Information through

1. Select one of the following two options: New Staff Member

   OR

   Current Staff Member
2. My Name:
3. My Email Address:
4. My Phone Number:
5. My Department:
6. My Work Description:
7. My Ministry:
8. My City:
9. My State:

   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

   
   
10. My Zip Code:
11. My Region is:

    HQ @ Lake Hart Red River Regional Office Southeast Regional Office MidSouth Regional Office Other

    
    

1. My Supervisor's Name:
2. My Supervisor's Email Address:
3. My Supervisor's Phone Number:

1. I have a question(s) I would like to ask: