New User Account

This form is only to be completed the the Executive Director (or specified delegate).

User's Personal Information

Please provide all PERSONAL information for the person needing an account.

Please USE actual information for the new user and not your organization's information.
First Last
Street Address City State / Province / Region Postal / Zip Code
Please use the person's PERSONAL information. Please DO NOT USE your organization's information to complete this form.
Home Phone Home Phone - ### - ### ####
Mobile Phone Mobile Phone - ### - ### ####
Alternate Email Address

This is the user's PERSONAL email address where the Welcome email will be sent.
Last Four Digits of Social Security Number
Must be 4 characters. Currently Entered: 0 characters.
This field will be used for the user's initial password.
User Information

This information is used to update miscellaneous contact systems used by MSS.
Position/Title
Job Description

Please provide a brief job description of the kind of work the new user will be doing. (This helps determine additional software applications and/or hardware that may be needed)
Start Date Start Date / MM / DD YYYY
Is this person replacing an existing or former employee?

Is this person replacing an existing or former employee? Yes No
Former employee
**** ATTENTION ****
Provisioning of a new user account with email address, security access, phone and updated personal computer can take a minimum of 2 DAYS and a maximum of UP TO 2 WEEKS. Please consider this and make arrangements accordingly.
Relationship to Organization

Relationship to Organization Full-Time Employee Part-Time Employee Volunteer Intern Temporary Other Other
Expected Length of Assocation

Expected Length of Assocation 1-4 weeks 1-3 months 4-9 months 12+ months Other Other

New User accounts will not be created for short-term users. Special "generic" accounts may be created instead (i.e. user1, temp1, guest1, etc...)
Where will this new user primarily work?

The user is considered to work "on-site" if time spent at work/office is 60% or greater.
On-Premises Requirements

On-Premises Requirements Desktop Computer (PC) Remote Access/Desktop Desktop Phone Building Security (keycard/keyfob) Workroom Printers Other Other
Shared Mailbox

Shared Mailbox Yes No

Does the user need access to any organizational shared mailboxes?
Please list shared mailboxes

Please list all shared mailboxes that the user needs access. (i.e. info@, admin@, ap@, etc.)
Primary OFFICE Location where user will be working. (Office Number can be found on door frame of each office within your Suite)
** THIS IS NOT YOUR SUITE NUMBER **
Must be 4 digits. Currently Entered: 0 digits.
Type of Security Access device requested

Type of Security Access device requested Keycard Keyfob Use Existing Card/Fob
Existing Security Access Card/Fob Number:
Minimum of 3 characters required. Currently Entered: 0 characters.
Please provide the existing keycard/keyfob number you are re-assigning to this new user.
Requestor Information

Please provide all information for the person making the request.

** Requests made by persons other than Executive Directors or their delegates may require written authorization and confirmation.
Your Name
Your Email
Affiliated Organization
*** PLEASE NOTE ***
For MSS Tenants, additional fees may apply for each user account that exceeds your organization's allocation, which is determined by the total number of PCs within an organization's suite.
Comments

Please provide any additional information or instructions that will help MSS best create the new user.

New User Account

New User Account

User's Personal Information

User Information

ATTENTION
Provisioning of a new user account with email address, security access, phone and updated personal computer can take a minimum of 2 DAYS and a maximum of UP TO 2 WEEKS. Please consider this and make arrangements accordingly.

Requestor Information

* PLEASE NOTE *
For MSS Tenants, additional fees may apply for each user account that exceeds your organization's allocation, which is determined by the total number of PCs within an organization's suite.

New User Account

New User Account

User's Personal Information

User Information

**** ATTENTION **** Provisioning of a new user account with email address, security access, phone and updated personal computer can take a minimum of 2 DAYS and a maximum of UP TO 2 WEEKS. Please consider this and make arrangements accordingly.

Requestor Information

*** PLEASE NOTE *** For MSS Tenants, additional fees may apply for each user account that exceeds your organization's allocation, which is determined by the total number of PCs within an organization's suite.

ATTENTION
Provisioning of a new user account with email address, security access, phone and updated personal computer can take a minimum of 2 DAYS and a maximum of UP TO 2 WEEKS. Please consider this and make arrangements accordingly.

* PLEASE NOTE *
For MSS Tenants, additional fees may apply for each user account that exceeds your organization's allocation, which is determined by the total number of PCs within an organization's suite.