SIS Service Request

This form is used by campus departments to submit ad hoc retrieval requests using applicant and student data from Student Information Systems. Upon receipt of a complete request form, you will be e-mailed a confirmation with a tracking number. Please note that the normal turn-around time is 10 working days.

1. Download the SIS Service Request Form
2. Complete the sections for Requestor Information, Result Processing, and Request Information.
3. Under the section for Authorization and Charging, enter the chart string account number for billing purposes.
4. Print the form.
5. Obtain the signature from your department business staff member for billing approval.
6. Obtain the signature of the proper retrieval security officer. The two contacts are below.
7. Mail or fax the completed form, with all signatures to:
   
   Student Information Systems
   Attn: Diane Lyman
   550 Banway Building #3816
   Berkeley, CA 94720
   Fax: 510-642-6897

Send request to:

Pam Ziehe
110 Sproul Hall
Berkeley, CA 94720-5800
Office: 510-642-8732
Fax: 510-642-7333

Send request to:

Russell Low
119 Sproul Hall
Berkeley, CA 94720-5404
Office: 510-642-7009
Fax: 510-643-9201