New Employee Account Request
  • All requests must be submitted by the employee's supervisor.
  • Self-submissions are not accepted.
  • All requests will be processed no sooner than 10 business days from the receipt of the request.
  • Please verify spelling of names, as this data is directly imported to create user accounts.
  • Please verify personal preference in first name usage (i.e., "Bill" instead of "William")
Employee Information (All fields are required)
First Name (Please verify spelling)

 

 Last Name (Please verify spelling)

 
Start Date

(mm/dd/yy)

 Title
Department/Workgroup

 

 Employee Type

 
Office Location (Room and Building, i.e., 200A)

 

  
Former Employee Being Replaced

If this employee is replacing a former employee please enter the name of the former employee.
Account Needs (All fields are required)
PC Requirements  
Telephone Requirements  
Existing Extension
Voicemail Account
Does this employee require voice mail?		  
Shared Drive Access
Will this employee need to access your department's network drives? If YES, please specify the network drive.
(For example: "nursing$ on calkins")
Distribution List Membership

(Choose the primary distribution list.  Enter additional distribution list memberships under 'Other Comments' section.
Printer Access

(Please list any printers this person will require access to)
Model the following employee's account 
(security/distribution groups)		 Employee's Name
Supervisor (All fields are required)
Supervisor's Name

 Supervisor's E-Mail

@qcc.mass.edu
Supervisor's Extension

 

  
Other Comments