Federal User Account Request

Instructions

This form must be filled out completely by the federal staff person submitting the request. The NYTD system administrator will verify all account requests as needed. Confirmation of approved requests, including initial account information for new users, will be sent to the email address provided in this form. Please note: Federal users must have a Personal Identify Verification (PIV) card to access the system.

* Denotes fields that are required.

1. * Request Type: Indicate the purpose of the user's request.

2. * User Role:Indicate the role-based access of the user. "Central Office" users have access to all state NYTD data file submissions. "Regional Office" have access to their respective Region's state NYTD data file submissions. "Data Analyst" users have the ability to view all data file submissions and can export data for analysis.

3. * Office: Indicate the user's agency/office (e.g. Children's Bureau):

4. * User First Name: * User Last Name:

5. * User Title:

6. * User Phone: * User Email:

If this is a request to add a new user, the user must sign and submit the "Federal User Security Compliance Statement" on the next page.

NYTD: National Youth in Transition Database

Federal User Account Request Form