Phishing Simulation Permission Request Form
Request approval to conduct an internal phishing simulation by providing requester details, simulation scope, timing, target audience, and authorization.
Requester and Organization Details
Full Name
*
First Name
Last Name
Job Title / Role
*
Organization Name
*
Department / Team
Work Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Phishing Simulation Request Details
Simulation Name / Campaign Title
*
Proposed Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Proposed End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Target Audience / Department(s)
Simulation Type
*
Email Phishing
Link-Only Phishing
Attachment-Based Phishing
Credential-Harvest Simulation
Vishing
Smishing
Expected Number of Recipients
*
Planned Tools / Platforms or Sending Domain(s)
Authorization and Approval
Approving Manager/Sponsor Name
*
Approver Title/Role
*
Approval Decision
*
Approved
Approved with Conditions
Needs Revision
Declined
Authorization Acknowledgement
*
I confirm permission to run the phishing simulation for the specified scope and dates
Submit Request
Should be Empty: