NUPD Information Technology Change Request Form

This form is to be used to begin the information technology change management process for user access to systems, changes or additions to current systems, or requesting department-issued electronic equipment. The purpose of this form is to formally communicate, document, review, approve, and implement any technology change or equipment request for the Northeastern University Police Department and its respective units.

  • Please identify the person initiating the request.
  • Please Enter Today's Date (or Future Date, if appropriate) for this Request
  • Contact Phone Number for this Request
  • Contact Email Address for this Request
  • Which NUPD Operational Unit is Authorizing the Request?
  • Request Information

    This section contains questions regarding your request.
  • What is the Nature of this IT Request?
  • (e.g. Change in Role/Assignment; New Hire; Server Upgrade; Damage to Equipment)
  • Please be as specific as possible about your request (e.g. Department-Standard Dell All-in-One Desktop PC)
  • NU Information Technology Services

    Only complete these fields if your request requires NU ITS involvement (e.g. Server Upgrades, University Admin Access, Project Implementation).
  • If ITS has been already contacted, please identify that here.
  • If there is a separate, ITS Integrator or Database Admin, please list them here.
  • What University systems will need to be integrated? Are their server requirements for the project? What type of information will be involved and is Information Security needed? Are there specific Servers being used - provide the IP information.
  • Submission and Processing

    Once submitted, the request will proceed through the following status changes: Documented, Approved, and Closed. Notifications will be sent to both the Unit Head and User Named in this Form. For any questions or issues with this form, please contact Todd Kaplan ( Thank you. Your Unit Head will be notified of the form submission and will be informed of approval status changes.
  • By checking the YES box, you are acknowledging that you have reviewed this request with your unit head/supervisor and it has been approved.
  • This field is for validation purposes and should be left unchanged.