Microsoft 365 User Request

Company Name*

Submitted By

Date Submitted

New User Information

User Start Date/Needed By

Computer to be used

PC S/N

PC Name

First Name

Last Name

Desired Domain Login (Username)*

Desired Domain Password

Needs remote access

Yes No

Desired Email Address*

Email Groups/Lists

Security/Distribution Group (Human Resources, Engineering, etc.)

Phone Setup

Additional Notes