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Coeus @ Purdue

User Access Request Form

Please complete all appropriate fields below and click the "Submit" button to request access to the Coeus system. When you fill out and submit this form, it will send an email notification to coeushelp@purdue.edu as well as send a confirmation to the user's email address. It will be your responsibility to notify your technical support staff if necessary.

* Indicates Required Field
Requested action: * What's this?
Access type: * What's this?
User Information
Full Name: *
Username: * What's this?
Home Department #: *
Departments
for creating
new proposals:		 Dept/SAP Cost Center #'s
Email: *
Phone:
Additional comments or instructions:

*COMPLETE BELOW FOR ADMINISTRATIVE USERS ONLY

Business Manager/Supervisor Information
Submission of this form indicates authorization by the Business Manager (or supervisor) for the use of the Coeus system to the person listed above. The email notification sent by this form will serve as an approval signature.
Name: *
Email: *
Phone: