Email Account Request Form

• Complete the User Information section. • Include your manager's name and email address at the end of the form. Your manager will receive an email notification requesting approval of your request. • Your acknowledgement and (print) signature will constitute you have read and accept the agreement. • New email accounts are usually created within five business days of receiving the request. Please note, your account information will be provided to you via the telephone number provided on the form.

Today's Date

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USER ACCEPTANCE

By signing this form I acknowledge that College systems may contain sensitive information. Non-adherence to Federal Law, State Law, and College Policies and Procedures can possibly result in criminal and civil penalties and loss of employment: https://www.mtsac.edu/governance/trustees/apbp/BP3720.pdf https://www.mtsac.edu/governance/trustees/apbp/AP3720.pdf https://www.mtsac.edu/governance/trustees/apbp/AP3721.pdf

I have read the and accept the agreement.

Please print full name.

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MANAGER APPROVAL

Please provide your manager's name and email for approval of this request.