New access request

Form 01. Complete before an account is created. It goes to the MPULIMS support team, and replies come to your email.

You

The person sending this form. Our replies go to this email.

Your name

Your email

Name and surname

PERSAL / staff ID

Username (if known)

Region / municipality

Library / office

Job title / assignment

The line manager confirms the duties. We may contact them before making the change.

Line manager name

Line manager email

The line manager knows about this request and agrees with the duties described

For example a signed paper form or an approval email.

Photos, screenshots, PDF or Office files. Up to 5 files, 10 MB each.