Account Creation / Modification Form Please allow 24 hours for account creation. Account disable will happen as soon as possible, once request is received. Department Manager Requesting Addition / Modification Email Address of Department Manager Requesting Addition / Modification Type of Action Requested Modify Account Create Account Disable Account Type of Account Requested Existing Employee New Hire Start / End Dates for Access New Hire or Employee Name Personal or Company Email Type of Account Requested Full Time Employee Existing Employee Part Time Employee Temporary Account Contractor Consultant Permission Level of Account Requested Non-Privileged Privileged Justification for Privileged Account Will the New Account Work from Home (WFH)? N/A Yes No Will the New Account Use a Personal Device for Work Purposes? No Yes N/A Will the New Account Require a Company Issued Laptop? N/A Yes No Justification for Laptop Will the New Account Require the Use of a Removable Media Device? (USB thumb drive, external hard drive, etc.) N/A Yes No Will the New Account Require a RingCentral Phone Extension? N/A Yes No Will the New Account Require Access to the Decatur Office Wireless Network? N/A Yes No Will the New Account be Authorized to Post Company Information to Systems Available to the Public? (email marketing campaigns, social media, etc.) N/A Yes No Additional Notes Submit Request