Account Application Form

Last Name *

First Name *

Middle Initial

Preferred Username *

Account Type *

Group Name *

Work Title *

Work Description (or, why account is needed) *

Public Account Required *

Office Room (Location)

End Date

mm/dd/yyyy

Phone

(###-###-####)

Sponsor Name

Group Machines Account Should Be Added To

Group Machine Home Path

Mail Forwarding

Contact Person For Questions *

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Manning College of Information and Computer Sciences | 140 Governors Dr., Amherst, MA 01003 | (413) 545-2744 | info@cics.umass.edu