IT Solution Request Form

Solution Request Name

Requestor or Sponsor

Name and Position

Requestor or Sponsor Email

Requestor or Sponsor Campus

Request Summary

Functionality

What specific functionality are you seeking from this solution?

Desired Outcome/ Benefits

Potential Impact on Operations

TDX Ticket

If there is a ticket associated with your request, paste the URL here

Estimated # of Users/ Beneficieries

Desired Timeline

Budget Approval

Has the campus Chief Business Officer (CBO) or Vice Chancellor approval been obtained? Please share relevant details.

Data Requirements

Please describe the data involved. Is legislatively managed data is involved in this request (HIPAA, GLBA, FERPA, etc.)? Will data from an existing system be required to meet this need?

Optionally, attach any additional documentation about the request

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