The University of Memphis
Request for Matrix Access
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Submit form to Business & Finance Support Services, 151 Administration Building.

Please ADD or  REMOVE the following employee's access within my area of responsibility:

Name:
User Name:
Department:
User Phone:  

As an employee of The University of Memphis (or acting as an agent of the University), I am aware that the data and materials to which I may have access are to be treated in a professional and confidential manner. I agree herein, as a consideration of my employment, that I will not disclose or cause to be disclosed any such confidential information gained in the course of my employment at any time.

I am aware that any breach of the confidentiality of this material or any abuse of my position, including but not limited to alteration of records, destruction of records or other similar acts, may result in disciplinary action or constitute a basis for termination of employment.

Employee Signature:_______________________________________ Date____________

I understand that the ultimate responsibility for any action taken by the above individual is mine.

Supervisor's Title:
Supervisor's Name: 
Supervisor's Signature: _______________________________________ Date___________
Contact Person:  
Contact Phone:  

 
FOR B&F SUPPORT SERVICES USE ONLY - DO NOT USE
WORK GROUP
ACCOUNTING
BURSAR
FINANCIAL PLANNING
HUMAN RESOURCES
PAYROLL
The University of Memphis, one of the Tennessee Board of Regents institutions, is an Equal Opportunity/Affirmative Action University.