iTech - University of Southern Mississippi

Request Form for New Organizational and Departmental Email Account

All accounts to be modified must be authorized by the appropriate department head.

Before requesting a modification to an account, please read the Web Account policy. By filling out this application, you agree to abide by the University of Southern Mississippi Web Account Policy.

Once your account is modified, you will be notified via email. For this modification, there will be no need to pick up anything from the Help Desk.

Please email us if you have any questions.

Department/Organization Information


* - Required Field
*Name of Applicant:
*Name of Applicant:	This will be the owner of the account, and must be an authorized department head or chair.
*Applicant's EmplID #:
*Applicant's Email Address:
*Name of Main User:
*Name of Main User:	This will be the person who will be using the account most often.
*Main User's EmplID #:
*Main User's Email Address:
*Phone Number:
Fax Number:
*P.O. Box Number for Department:
*Official USM Dept. or Org. Name:
*Preferred Email Name (for account):
*Preferred Email Name (for account):	This will be an @usm.edu address. Please do not include spaces in your requested email address.
*List email addresses and EmplIDs that should receive email for this account (hit your enter key after each entry): Example: John.Doe@usm.edu 101101 Jane.Doe@usm.edu 100100

You may not be able to use some Email Names. If an Email name is already in use, you will need to use an alternate choice. Someone will contact you concerning your email address. An example of an email name could be Basket.Weaving@usm.edu

*Please tell us how you plan to use this email account:

By submitting this form, you agree to use this account as stated in The University of Southern Mississippi policies as linked on the main page. Also, you affirm that the information on this form is correct.