DARDEN RESTAURANTS DATA SECURITY REQUEST FORM

Requestor: ______Date: ______Date Required: ______

Approval: ______Dept#: ______Extension: ______(Director or above) ______

Account Information

Name: ______Job Title: ______Extension: ______(Middle Initial Required)

Dept#: ______User ID: ______(New user completed by security dept.)

Check one: New User: ______Dept Transfer: ______Modify User: ______

Check Requested Access

SSL-VPN Access: _____

RANDSTAD EMPLOYEES: DATE OF BIRTH ______LAST FOUR DIGITS OF SS# _____

_____ E Mail _____ Franklin Machine Parts _____ Office Ordering – Office Supply _____ SteriTech Food Safety _____ Learn Something – RL Manager Certification _____ Synaptis PeopleSoft Train _____ Buntin Outdoor – RL Outdoor Advertise _____ TOG Merchandise _____ Directions Research Consumer Database _____ Total Quality Audit _____ RL Premium Merchandise – All RSC access _____ Service Mgmt Group _____ VIP Facilities Server _____ FM Pilot (Facilities Field)

______

Additional Approval Needed for Access

Hyperion: ______(Approved by Jeff Horn)

Restaurant Profile: ______(Approved by Beth Stute) RESTPROF Facility Server ______Restaurant DiSH Access from RSC (select access level and concept-additional concepts will need the concept approval)

ACCESS LEVEL: Manager ____ SVP ____ Director ____ HelpDesk ____ Super User ____

CONCEPT: RLUSA _____ RLCAN _____ OGUSA _____ OGCAN ______BB _____ EddieVs_____

SEASONS 52 ______LONGHORN_____ CAPITAL GRILLE ____ SPECIALTY REST._____ YH______

List Department Security Groups: ______

Additional Comments: ______

Business Intelligence (complete this page and Business Intelligence documents with approvals)

Oracle (complete this page and the Oracle document)

FAX to Kaye Rahberg (407 241 6262)