Technology Account Creation Form (Cumberland)

This form is to be completed by the Supervisor of the new hire or by one authorized to complete on behalf of the Supervisor.

Home Campus (paid by which campus)

Employee's Supervisors's Name

Start Date

Start date of the employee

Employee's ID number (contact HR if not known)

Cumberland Colleague ID Number

Employee's First Name

Employee's Last Name

Employee's Position Title

Employee's Cell Phone Number

Employee's RCSJ Email Address

The employee's email address should be formatted, like this: username@rcsj.edu

Employee's Alternative Email Address

Required so IT can email inform employee of completion of this request.

Employee's Department

Employee's Office Location and Room #

New hire or Replacement hire

Is the person that is being hired a new position or replacing an existing position?

Name of Previous Employee in the Position (if applicable)

Helpful when replicating system accesses.

Employee Type

Full-Time Faculty

Full-Time Staff

Part-TIme Faculty (Adjunct)

Part-Time Staff

Part-Time Student Worker

Other

Other Description

Employee Needs...

A computer provided by the college

A phone in the office (only for full time faculty and staff)

Other

Other Needs

Questions or Comments

Other Fields

Your name

Your email address

Verification Code