VPN Access Request Form Instructions

When applying for VPN Access, provide all requested information. Answering questions fully will facilitate subsequent communications and help avoid delays. Access Login to the CCNY VPN Access Request Form (Login Required).

Form Instructions

If you are filling this form out for Yourself:

Section 1: Requestor information
Provide all requested information. Requestors must provide a CCNY email address and phone extension; alternative phone numbers and email addresses may also be provided.

Section 2: Justification for VPN
Provide an overview of the intended use of the VPN, who will be using it, and for how long. For example, the CCNY Acme Research Group is requesting a VPN to allow a national consortium of researchers access Platform from September 2017 until December 2020 to a CCNY-based research cluster using the Gadget Software.

Section 3: CCNY System(s) You Need to Access
Enter the information of the system(s) that you will need access to.

  • IP: IP address of the computer
    Hostname: The name of the computer
    Operating System (Version): Name and version of the operating system installed
    Anti-virus / Anti-malware: Name and version of anti-virus software installed

Section 4: System Administrator
If the requestor’s departmental IT system administrator was consulted on this request, please provide their contact information. Departmental IT administrators can be an invaluable resource in remediating vulnerabilities detected by security scans. If the system is managed by OIT, check Manage by OIT.

Section 5: Supervisor
VPN requests must be approved by the requestor’s supervisor. Provide his or her CCNY employee email address. In some circumstances additional approval may be required by a Dean or AVP or VP overseeing the area, for example when sensitive information or areas are involved.

Section 6: Non-Public University Information Disclaimer
Non-Public University Information (NPUI) are subject to many regulations, including Family Education Rights and Privacy Act (FERPA), Health Insurance Portability and Accountability Act (HIPAA), and Payment Card Industry Data Security Standard (PCI-DSS) regulations and CUNY information security policy. These types of information have specific security requirements that must be adhered to.

The requestor must indicate whether any NPUI may be exposed by the requested VPN Access, including any of the following types of protected information: Social Security numbers, citizenship status information, birthdates, debit and credit card numbers, userids with passwords, student records (e.g., GPAs, transcripts, grades, test results), financial records (e.g., tax information, bills, insurance records, payroll information), health records, drivers licenses or other government-issued identification.

Section 7: Information Security Statement
Users of CCNY network and computer resources are subject to CUNY security policies and procedures, especially the Acceptable Use of Computing Resources and IT Security Procedures: General. See the CUNY Information Security website for CUNY security policies.

If you are filling this form out for a Subordinate:

Section 1: Supervisor Information
This is your information as supervisor of the individual needing access.

Section 2: Subordinate(s) Information
This is the Department and Access Date information of the individual(s) needing access.

Section 3: Justification For VPN
Provide an overview of the intended use of the VPN, who will be using it, and for how long. For example, the CCNY Acme Research Group is requesting a VPN to allow a national consortium of researchers access Platform from September 2017 until December 2020 to a CCNY-based research cluster using the Gadget Software.

Section 4: CCNY System(s) you need to access
Enter the information of the system(s) that you will need access to.

  • IP: IP address of the computer
    Hostname: The name of the computer
    Operating System (Version): Name and version of the operating system installed
    Anti-virus / Anti-malware: Name and version of anti-virus software installed

Section 5: System Administrator
If the requestor’s departmental IT system administrator was consulted on this request, please provide their contact information. Departmental IT administrators can be an invaluable resource in remediating vulnerabilities detected by security scans. If the system is managed by OIT, check Manage by OIT.

Section 6: Non-Public University Information Disclaimer
Non-Public University Information (NPUI)  are subject to many regulations, including Family Education Rights and Privacy Act (FERPA), Health Insurance Portability and Accountability Act (HIPAA), and Payment Card Industry Data Security Standard (PCI-DSS) regulations and CUNY information security policy. These types of information have specific security requirements that must be adhered to.

The requestor must indicate whether any NPUI may be exposed by the requested VPN Access, including any of the following types of protected information: Social Security numbers, citizenship status information, birthdates, debit and credit card numbers, userids with passwords, student records (e.g., GPAs, transcripts, grades, test results), financial records (e.g., tax information, bills, insurance records, payroll information), health records, drivers licenses or other government-issued identification.

Section 7: Information Security Statement
Users of CCNY network and computer resources are subject to CUNY security policies and procedures, especially the Acceptable Use of Computing Resources and IT Security Procedures: General. See the CUNY Information Security website for CUNY security policies.

If you are filling this form out for a Non-CCNY user(s):

Section 1: Requestor Information
Provide all requested information. Requestors must provide a CCNY email address and phone extension; alternative phone numbers and email addresses may also be provided.

Section 2: NON-CCNY Personnel Information
Please provide the contact information of such individuals, including contractors, external research associates, consultants, or any other individuals or groups who will access campus-based resources via VPN.

Section 3: Justification For VPN
Provide an overview of the intended use of the VPN, who will be using it, and for how long. For example, the CCNY Acme Research Group is requesting a VPN to allow a national consortium of researchers access Platform from September 2017 until December 2020 to a CCNY-based research cluster using the Gadget Software.

Section 4: CCNY System(s) you need to access
Enter the information of the system(s) that you will need access to.

  • IP: IP address of the computer
    Hostname: The name of the computer
    Operating System (Version): Name and version of the operating system installed
    Anti-virus / Anti-malware: Name and version of anti-virus software installed

Section 5: System Administrator
If the requestor’s departmental IT system administrator was consulted on this request, please provide their contact information. Departmental IT administrators can be an invaluable resource in remediating vulnerabilities detected by security scans. If the system is managed by OIT, check Manage by OIT.

Section 6: Dean / Chair / Director Information
OIT will be requesting Dean, Chair, or Director of the department approval. Enter the name, email and phone number of the Dean, Chair, Director, AVP or VP of your department.

Section 7: Non-Public University Information
Non-Public University Information (NPUI) are subject to many regulations, including Family Education Rights and Privacy Act (FERPA), Health Insurance Portability and Accountability Act (HIPAA), and Payment Card Industry Data Security Standard (PCI-DSS) regulations and CUNY information security policy. These types of information have specific security requirements that must be adhered to.

The requestor must indicate whether any NPUI may be exposed by the requested VPN Access, including any of the following types of protected information: Social Security numbers, citizenship status information, birthdates, debit and credit card numbers, userids with passwords, student records (e.g., GPAs, transcripts, grades, test results), financial records (e.g., tax information, bills, insurance records, payroll information), health records, drivers licenses or other government-issued identification.

Section 8: Information Security Statement
Users of CCNY network and computer resources are subject to CUNY security policies and procedures, especially the Acceptable Use of Computing Resources and IT Security Procedures: General. See the CUNY Information Security website for CUNY security policies.

Please take time to explore information security resources on the CCNY Information Security website.