Case Study ‘Employee Benefits System’

<INSERT COMPANY NAME HERE>

Phone: Fax:

DATE OF REQUEST

SERVICE REQUESTED FOR DEPARTMENT(S)

MM/DD/YYYY

SUBMITTED BY (key user contact)

EXECUTIVE SPONSOR (funding authority)

Name

Name

Title

Title

Office

Office

Phone

Phone

BRIEF STATEMENT OF PROBLEM, OPPORTUNITY, OR DIRECTIVE (attach additional documentation as necessary)

BRIEF STATEMENT OF EXPECTED SOLUTION

ACTION (ISS Office Use Only) FORMCHECKBOX Feasibility assessment approved Assigned to _<name of student>_

FORMCHECKBOX Feasibility assessment waived Approved Budget $ _____________ Start Date __ _____ Deadline _ ___

FORMCHECKBOX Request delayed Backlogged until date: ______________

FORMCHECKBOX Request rejected Reason: ________________________________

Authorized Signatures:_________ _________________________________ Project Executive Sponsor