MWA LAOs: Please fill out the following form for creation of a new NFC
User ID. Fax this form to:

Paula Snell

Area IT Specialist

USDA-ARS-MWA

FAX - 309-681-6576

+-----------------------------------+-----------------------------------+
| NFC Access Request                |                                   |
+-----------------------------------+-----------------------------------+
| □ **Add User**                    | **User Name:**                    |
|                                   |                                   |
| □ **Modify User User ID?          |                                   |
| [\_\_\_                           |                                   |
| \_\_\_\_\_\_\_\_\_]{.underline}** |                                   |
|                                   |                                   |
| □ **Delete User**                 |                                   |
+-----------------------------------+-----------------------------------+
| **Social Security Number:**       | **User Phone Number:**            |
+-----------------------------------+-----------------------------------+
| **NFC Programs:**                 | **Address:**                      |
|                                   |                                   |
| □ CULPRIT                         |                                   |
|                                   |                                   |
| □ FFIS/FDW                        |                                   |
|                                   |                                   |
| □ FOCUS                           |                                   |
|                                   |                                   |
| □ MASC                            |                                   |
|                                   |                                   |
| □ PINQ/IRIS                       |                                   |
|                                   |                                   |
| □ PRCHINQ Requisitioner Number:   |                                   |
| \_\_\_\_\_\_\_\_\_                |                                   |
|                                   |                                   |
| □ PROP                            |                                   |
|                                   |                                   |
| □ STAR-Web Contact Point:         |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  |                                   |
|                                   |                                   |
| □ TRVL OON:                       |                                   |
| \_\                               |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| ORG:                              |                                   |
| \_\                               |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| □ TUMS                            |                                   |
|                                   |                                   |
| □ OTHER:                          |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\       |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
+-----------------------------------+-----------------------------------+
|                                   | **User Email Address:**           |
+-----------------------------------+-----------------------------------+
|                                   | **Mode Code:**                    |
+-----------------------------------+-----------------------------------+
|                                   | **UPrinter?** Y/N                 |
+-----------------------------------+-----------------------------------+
| **Did the User Replace Someone?   | **VPN Access?** Y/N               |
| Y/N**                             |                                   |
|                                   |                                   |
| **If so, who?**                   |                                   |
+-----------------------------------+-----------------------------------+

If this user will access FFIS/FDW, please complete the AD-1143 found at
<http://www.mwa.ars.usda.gov/mwa/adp> and fax to Paula Snell,
309-681-6576. Mail original

AD-1143 to Paula Snell, USDA-ARS-MWA, 1815 N. University, Peoria, IL
61604.