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Submit a Request for Help

Account Request Form

Please fill out all appropriate information and click the SUBMIT button at the bottom.
Your request will be automatically sent, and processed.

Any questions/problems can be directed to the Help Desk, 871-2371

Note: Items labeled in RED are required fields.

Contact Information (If not Requester)

Name:

Telephone:

Requester Information

First Name:			Middle Initial:
Last Name:
Job Title:
M-Number:			Telephone:
Department:
Campus Address:

Type of Account/Employee

Faculty	Grad. Assistant	Temp. Employee
Staff	Student Employee	Generic/Dept. Acct

Computing Platform

PC (Windows 98/XP/etc)

Apple (Mac OS 8/9/X)

Other/Unknown

Email

Individual Account

Alternate Account Name (optional):

When available, the default format is Firstname.Lastname@millersville.edu.
(eg: Johnathan.Doe@millersville.edu)

Alternate formats are available at individual's request.
(eg: John.Doe@millersville.edu, Jack.Doe@millersville.edu)

When an alternate format is requested, both default and alternate addresses are valid.

Department, Functional, Group

Accounts for entire departments, or other multi-user mailboxes.
(eg: YourOffice@millersville.edu)

Alternate formats are available at individual's request.
(eg: DeptarmentName@millersville.edu)

When an alternate format is requested, both default and alternate addresses are valid.

Requested Account Name:

Alternate Account Name (if needed):

Primary User:

Other Users Needing Acccess:

Banner/Brio/SAP

Type of Account:	SAP (PASSHE)	Banner	Brio
Banner Modules¹:	Finance²	Student³	Both
SAP Finance Modules:	Finance	DataWarehouse	Both
Access to Banner Accounts Receivable, Alumni, and Financial Aid must be requested through the appropriate department's Banner Security Administrator To complete a Banner Finance request, a Banner Finance Security form must be completed and sent to the Accounting Office. (This form can be found in Outlook, at: Public Folders / All Public Folders / Accounting Office / Forms / BCS Security form.doc ) To complete a Banner Student request, a memo or email must be sent to Rachael Wywadis in the Registrar's Office