Requestor Company
*
Requestor Name
*
First Name
Last Name
Requestor Email (this is your email address)
example@example.com
When do you need this completed by?
-
Month
-
Day
Year
Date
What is the new Users Name? - First Name and Last Name
*
New User's Title
*
Department
Manager
Critical Team Member? (First Priority for Service)
Please Select
Yes
No
Accounts Requested (please select all that apply)
Windows Logon (AD)
Microsoft 365 (Email)
No Email (Software Only)
Primary Email Address (Temporary password will be set and new user will need to change on first login if next field is empty)
example@example.com (leave blank if none)
Password Request
If you would like to request a password please type it above.
Office 365 Account Level
Please Select
No Software, Just Email
Default and comes with desktop software
What Email groups will the new user need to be added too?
i.e. Sales, Marketing, etc.
Additional Software (CRM, ETC)
Phone Extension
Direct Dial Information
Cell Phone (if you want it added to signature)
Special Email Signature Needs? (marketing message, disclaimer, etc.)
Desk Location
Will this user be seated at an existing PC location?
Equipment Needed (i.e. – desktop, laptop, mobile device, use of special printers)
Special Program Needs: (i.e. – CRM, Sage 300 access, specialty marketing software, etc)
Additional Shared File Access
Additional Connection Needs
VPN Access
LogMeIn
Preview PDF
Submit
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