SSO Admin Access Request Form
Request single sign-on administrative access. Please complete all fields accurately to ensure timely provisioning of your SSO admin access.
Full Name
*
First Name
Last Name
Work Email Address
*
example@example.com
Department or Team
*
Please Select
Engineering
IT
Product
HR
Operations
Finance
Other
Job Title or Role
*
SSO Platform/System Requested
*
Please Select
Okta
Azure AD
Google Workspace
JumpCloud
Other
Access Level Requested
*
Full Admin
Group Admin
Read-Only Admin
Other
Reason for Admin Access
*
Manager/Supervisor Name
*
Manager/Supervisor Email
*
example@example.com
Target Start Date for Access
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Request
Should be Empty: