Marketing Automation User Deactivation Form for UW-Madison
Individual(s) to be Deactivated
Email Address
*
(of the user to be deactivated)
NetID (ex. BBadger):
*
For any individual needing deactivation
Email Address
For any additional individuals needing deactivation
Net ID
Email Address
NetID
Requestor's Name
First Name:
*
Last Name:
*
Email Address
*
Campus Department or Program
*
Electronic Signature
*
Your Authorization
Today's Date
*
vERTHED1stGenerationCollegeStudent
