Non-Person Account Request Form

Account Information
Account Display Name*
Account User ID*
20 character limit, letters & numbers only
Account Description*
Minimum: Single sentence describing purpose/function of requested account
How do you plan to use the non-person account?

Email communicationShared computer login
Account Manager*

First NameLast Name
Account Manager Net ID*
Account Division*

Central AdministrationNSSRParsonsLangNSPEMannesDramaJazz
Supervisor Authorization and Approval*

First NameLast Name
Supervisor's Telephone Extension*
Supervisor's Email*
Supervisor's Signature*

Clear
Should be Empty:

Account Information