App Name: Click here to enter text.

Access URL: Click here to enter text, if applicable.

Docs URL: (if any) Click here to enter text. Where can people find further info on the app?

IC: Click here to enter text. Provide your IC acronym

Submitter Name: Click here to enter text.

Email Address: Click here to enter text. Phone Click to enter text.

Functional Area Where Used:

Choose an item. How Acquired? Choose an item.

App IT Contact: Click here to enter text.

Operating Sys: Click here to enter text. DBMS Click here to enter text.

Front End: Click to enter text.

We intend to:

FUNCTIONALITY PROVIDED

[Type a description of the activities enabled by this application. Please add sufficient detail while keeping this table to one page. If you choose “FYI/other” for why you are showing the app, please tell us more about your intent in the email when you return this form.]

NUMBER AND TYPE OF CURRENT USERS

[Describe the current user base for this application.]

EXTERNAL DATA USED

[Describe any data from other sources (e.g. IMPAC II, HRDB) used within this app.]

ADDITIONAL NOTES

[Type any additional notes if needed.]