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Community College of Rhode Island

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Campus Domain Account Application Form

This form is only for new or returning hires.  It grants staff or faculty members a CCRI domain account,  email address and department share drive access if needed.  Please complete the form, print it and have it signed by the department head.  Return to: Human Resources, Knight Campus – Room 3118.

You must fill this form out before you print it. Return it to: Human Resources, Knight Campus - Room 3118.

For shared drive access for an existing staff member, please use this online form.

For the creation of a department or club email, please use this online form.

For the creation of a student worker account, please use this online form.

Please have the applicant provide the following information: (Please Type) To be filled by department chair or manager. (Please Type) If Yes, fill in a termination date.
Student email accounts will be deleted when a staff email account is created. We recommend backing up and forwarding any data in the account they wish to keep before submitting this form.
This form will automatically grant the staff or faculty member an email account. Check any share drive access they may need.

Agreement: I have read, understand, and agree to comply with the CCRI Data Security Policy and the CCRI Policy on the Responsible use of Information Technology. I understand that I am responsible for any computing activity carried out using this account.

Routing: (This is the only area to be filled out by hand.)

Applicant's Signature:________________________________________________________________

Print Name:____________________________________________________ Date: _______________

Department Head's Signature:_________________________________________________________

Print Name:____________________________________________________ Date: _______________

To be filled by Human Resources. (Please Type)
CCRI ID Number:________________________________________________
To be filled by IT. (Please Type)

Date Acct. Created: ____________________  Initialed:___________

Remember! You must fill this form out
before you print it. Thank you.

Last Updated: 4/17/17