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Shipper Access Request Form
"
*
" indicates required fields
Legal Company Name:
*
Access Type:
*
Add
Modify
Deactivate
Check Applicable Assets
*
AGS
BRD
BSP
SGG
TIO
W10
Blue Union
LEAP
MIG
Name:
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Middle
Last
Office Phone:
*
Cell Phone:
*
Title:
*
Work Email:
*
Department Email:
IM:
Name:
*
First
Last
User ID:
*
Email
*
What would you like to modify?
*
Name of Person to Remove:
*
First
Last
Requestor:
*
Phone:
*
Email:
*
Registered Authentication Email, if different from Work Email:
Describe Your Role/Access Level
Please select all that apply.
Scheduler
Scheduler
Accounting
Accounting
Measurement
Measurement
Operator
Operator
Marketing
Marketing
Contract Administrator
Contract Administrator
Notifications Requested
Please select all that apply.
Invoice Ready
Contract Reminder
Nomination
Operator Confirmation
System Wide Notices
Capacity Release (BRD/W10 Only)
OFO Notifications (BRD/W10 Only)
Imbalance Trading (BRD Only)
Email
This field is for validation purposes and should be left unchanged.