Purpose of the Department E-Mail Account Request

Department E-mail Account Request

Information Technology Services Form ITS-8818 RevF 11-14-13Page 1 of 3

Purpose of the Department E-mail Account Request

University business processes may require a general e-mail account for a specific department or centralized purpose that can be accessed or monitored by multiple account holders. Department e-mail accounts must adhere to the same standards, security measures and audit compliance requirements as individual mailboxes. Eachdepartment e-mail account must have an owner who is responsible for adding, changing and removing designees. All owners and designees, including student assistants, must agree to abide by the Acknowledgement of Confidentiality and Appropriate Use Agreements, available onlineat

Instructions

Use this form to apply for, or modify a previous request for, an e-mail account for a college, division, executive office, department, business unit, organization or special purpose (e.g., to collect survey responses). Fill in all the requested information in the fields provided below, and obtain all the required approval signatures. Submit the completed form to the ITS Help Desk, LIB PW Lobby. Failure to fill out this form completely and accurately may result in a delay in processing your request.

Check one: New Account Request Complete sections 1, 2, 4and A. Complete sections 5,and B and C, if applicable.

Ownership Transfer Complete sections 1, 2, 3and A.

Employee Designee Changes Complete sections 1, 2, 4and A.

Student Assistant Designee Changes Complete sections 1, 2, 5, and B and C.

Account Deletion Complete sections 1, 2 and 6.

Section 1 – New or Current Department Mailbox Owner Information

Name / Office Location (Building / Room)
/ / Office Phone
Title / Department/Business Unit / myCSULA Identity
Employee ID (CSULA One Card ID#) / College/Division / Status
Faculty Staff MPP

Section 2 – Mailbox Information

Check one: New Mailbox Existing Mailbox Change Existing Mailbox Name *
Mailbox Name:
New Mailbox Name: * / Mailbox on Global Address List
Hide from view
Display on GAL
* Note: A mailbox name change affects the e-mail address, which in turn could affect another department’s or individual’s distribution list.

Section 3 – Transfer Ownership from Current Owner to This New Owner

Name / Building / Room
/ / Office Phone
Title / Department/Business Unit / myCSULA Identity
Employee ID (CSULA One Card ID#) / College/Division / Status
Faculty Staff MPP

Section 4 – Addor Remove Employee Designees

Employee ID is the campus identification number (CIN) on your CSULA One Card.
myCSULA Identity is the credentials used to log into campus e-mail and networks.
Contact your ITC to help new designees open this additional mailbox in Outlook using their existing e-mail account.

1 / Add Designee (Complete all fields) / Remove Designee (Only fields with * are required)
Name * / Phone / Building / Room / Faculty * / Staff * / MPP *
Title / Employee ID / myCSULA Identity *
2 / Add Designee (Complete all fields) / Remove Designee (Only fields with * are required)
Name * / Phone / Building / Room / Faculty * / Staff * / MPP *
Title / Employee ID / myCSULA Identity *
3 / Add Designee (Complete all fields) / Remove Designee(Only fields with * are required)
Name * / Phone / Building / Room / Faculty * / Staff * / MPP *
Title / Employee ID / myCSULA Identity *
4 / Add Designee (Complete all fields) / Remove Designee (Only fields with * are required)
Name * / Phone / Building / Room / Faculty * / Staff * / MPP *
Title / Employee ID / myCSULA Identity *
5 / Add Designee (Complete all fields) / Remove Designee (Only fields with * are required)
Name * / Phone / Building / Room / Faculty * / Staff * / MPP *
Title / Employee ID / myCSULA Identity *

Section 5 – Addor Remove Student Assistant Designees

Student ID is the campus identification number (CIN) on your CSULA One Card.
myCSULA Identity is the credentials used to log into campus e-mail and networks.

1 / Add Student Designee (Complete all fields) / Remove Student Designee (Only fields with * are required)
Name * / Phone / Building / Room / Student ID (Golden Eagle Card ID #)
Title / Supervisor’s Name and Phone / myCSULA Identity*
2 / Add Student Designee (Complete all fields) / Remove Student Designee (Only fields with * are required)
Name * / Phone / Building / Room / Student ID (Golden Eagle Card ID #)
Title / Supervisor’s Name and Phone / myCSULA Identity*

Section 6 – Delete the Department Mailbox

The mailbox named in section 2 can be permanently deleted immediately.
The mailbox named in section 2 can be permanently deleted effective:.

Section A – Employee Acknowledgement of Confidentiality and Appropriate Use of Access

Click here to read the University’s Employee Appropriate Use Agreement.

I have read and understand the conditions outlined in the online Employee Appropriate Use Agreement, and by signing this form, agree to abide by them. I will maintain the security and confidentiality of any institutional records and information entrusted to me as stated in the agreement. If there is reason to believe there is a violation of University computer security, FERPA, and/or state or federal laws, statutes and regulations, I understand that my access, account(s), account contents may become subject to monitoring and examination by authorized personnel.

Mailbox Owner: Date:

Designee: Date:

Section B –Supplemental Acknowledgement of Confidentiality and Appropriate Use of Accounts by Student Assistants

Click here to read the University’s Employee Appropriate Use Agreement and Supplemental Acknowledgement of Confidentiality and Appropriate Use of Accounts by student assistants.

I, a student assistant,have read the above two agreements, and understand and agree to abide by the conditions outlined in both documents.

Student Signature:Date:

Section C – Supervisor’s Certification

I certify that the student assistants named as designees on this request form have read and understand the terms and conditions of the Acknowledgement of Confidentiality and Appropriate Use of Account agreementsabove.
I understand that to access the department mailbox, the student assistants named as designees on this request formmust usetheir own myCSULA Identity to access the mailbox.
I certify that the department mailbox requested or named on this form does not have the potential to receive Level 1 Confidential Data(e.g., SSNs, grades, financial aid data, disciplinary action items, account numbers).
I certify that I will supervise any student assistant use of the department e-mail account named in this request form.

My signature below confirms that I have read and understand the items listed above, and that I will fully abide by them.

Supervisor’sName Supervisor’s Title

Signature:Date:

APPROVALS

Approvers affirm that the job duties of each designeejustify access to the department e-mail account. It is the department chair/manager's responsibility to notify Information Technology Services when status of any designee changes. The approval of only one of the following is needed to remove an owner’s or designee’s access: department chair, manager,dean, or appropriate director.

Department Chair/Manager: Date:

Dean/Director: Date:

Executive Director UAS(for UAS employees only): Date:

FOR ITS USE ONLY

APPROVALS:

Director, IT Security and Compliance: Date:

FOR ITS TECHNICAL STAFF USE ONLY

Received by: / Date Received: / Date Fulfilled:
Network ID: / E-mail Address: / Full E-mail Alias: