New Distribution Group Request Form   

 
 
 Information on Group
E-Mail Address:      
     (Please ensure that desired username is not already in use)
Display Name:      
     (This is how the Group will appear in the Global Address Book)
Managed By:      
     (Manager will be authorized to make changes to this group)
     
(This MUST be a user in the state email system) 
Group Members:      
     (Please provide usernames.  Separate by using a semicolon)
     
(e.g. JDoe; EITShelp; ASmith)
Budget Code:      
 
Information on Requester
First Name:      
Last Name:      
E-Mail Address:      

   
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