Customer Details Requester Name Requester First Name Requester Last Name Requester Email Department/Organization Campus Address Campus Phone Number Requester Status - Select -FacultyPostdoctoral StudentGraduate StudentUndergraduate StudentStaff Local IT Support Name (non-UCSB customers, please provide the name of your campus' Local SCRE Sponsor) Authentication Details Primary Authentication for the SCRE is provided by your UCSBNetID/password. If you don't know your UCSB NetID, contact Identity Services. Requester UCSB NetID Please provide your UCSB NetID, if you have one. If you are a customer from another UC campus, please type non-UCSB in the field. Please provide your UCSB netid. Secondary Authentication for the SCRE Is provided by Duo Security, which provides several flexible methods for authentication: Duo Mobile (app that runs on mobile devices like smartphones and tablets) SMS text messages Duo phone callback Do have a mobile phone or tablet? - Select -YesNo Please provide at least one 10-digit landline phone number (no punctuation) that you can use for callback by Duo Security secondary authentication. The Duo callback authentication method will be used if you do not have a Duo Mobile-compatible device, or your primary Duo Mobile-compatible device is unavailable. This should be a home/office number different from your Mobile Device phone number. You may enter multiple numbers separated by commas. Alternate Landline Telephone Numbers Please provide at least one 10-digit landline phone number (no punctuation) that you can use for callback by Duo Security secondary authentication. The Duo callback authentication method will be used if you do not have a Duo Mobile-compatible device, or your primary Duo Mobile-compatible device is unavailable. This should be a home/office number different from your Mobile Device phone number. You may enter multiple numbers separated by commas. Mobile Details Mobile Device OS - Select -iOSAndroidBlackberryWindows PhoneOther Mobile Device Type - None -PhoneTablet Mobile Device Phone Number Project/Restricted Dataset Details Primary Investigator Name Primary Investigator First Name Primary Investigator Last Name Primary Investigator Email Restricted Dataset Name Restricted Dataset Provider Please enter the name of the agency or organization providing access to the restricted dataset. Method of Dataset Receipt - Select -Optical MediaFlash DriveOther Dataset Additional Notes Project Date Begin We require at least 7 days advance notice for creation of a Research Virtual Desktop We require at least 7 days advance notice for creation of a Research Virtual Desktop. Expected Project End Date Expected project end date Agency-Sponsored Research - Select -YesNo Agency Info Agency Data Security Plan Required - None -YesNo Have you received approval from the UCSB Technology and Industry Alliances office? - None -YesNo Have you already received approval from the UCSB Technology and Industry Alliances office? Have you received approval from the UCSB CISO? - None -YesNo Have you received approval from CISO Sam Horowitz? Export of Data Allowed by Agency - None -YesNo Secondary Approval Required by PI for Export of Data - None -YesNo Secure Backup of Data Allowed by Agency - None -YesNo Additional Notes about Agency Requirements Virtual Desktop Details Do you need to share access on the same Research Virtual Desktop with another authorized Researcher on your Project? (Otherwise, each Researcher will receive his/her own individual Research Virtual Desktop and need to share files manually via the File Transfer Gateway application) Multi-User VM Needed - Select -YesNo Multi-User VM Users If you need to share access to the same Research Virtual Desktop with another authorized Researcher on your project, please provide his/her name(s) here, along with UCSB NetIDs. Your Research Virtual Desktop will be assigned a secure, encrypted volume to hold the restricted dataset and all interim research results. Three size options are available for this volume based on your expected research data size. Size of Your Encrypted Volume Used as a "Working Area" for Restricted Data - Select -8 GB16 GB32 GB This is the size of your encrypted volume used as a "working area" for restricted data Backup of Encrypted Volume Requested? - Select -YesNo You may request regular backup of your Encrypted Volume, where the restricted data and your working files live. (Backup must be permitted by restricted data provider.) You may request regular backup of your Encrypted Volume, where the restricted data and your working files live. (Backup must be permitted by restricted data provider.) Current list of standard software which is pre-installed and licensed on standard Research Virtual Desktop image: Acrobat XI Professional Irfanview Mathematica 10 Microsoft Office 2013 Professional Notepad++ R R Studio SPSS 22 Additionally, some software is pre-installed on the standard Research Virtual Desktop image, but a limited pool of licenses are available for use. Activation of the following software licenses must be specifically requested. Do You Need to Use Stata SE/13 Software? - None -YesNo Do You Need to Use ArcGIS Pro Software? - None -YesNo Select the pre-installed software below that you will provide your own license for: SAS JMP 11 Atlas.ti Please provide additional information about your User-Provided License Please provide additional information about your User-Provided Software Other User-Provided Software and Licenses - Select -YesNo Please provide additional information about your User-Provided Software Financial Details Financial details may be required if you are requesting extra-cost software packages. Account/Fund/Sub Account Controller Name Submit