Information Technology Services | Network Account Request

*Employee First Name:
*Employee Last Name:
*Email Address: Must be a valid CNU address
Position:
Department:
Phone#
Other Details (Group / Folder)
By completing this form, I verify that I am the supervisor of the employee above and I request this Galileo account be created as stated.
Your email address in lieu of signature:
Supervisor Name:
Supervisor Phone#

The supervisor will receive a confirmation email with all pertinent information regarding the new employee's account.
Click Submit ONLY ONCE!