Add New User

Please complete the following form in its entirety so that we may add the new user to your system. Please keep in mind that it may take up to 24 hours for your request to be processed. If this request is time sensitive, please complete the form and then contact Support regarding your request.

New User Information

Employee's Full Name

Employee's Job Title

Employee's Email Address

Add Employee to the following Email Distribution Lists

Start Date

Equipment Order

Do you need Mode5 to procure a new PC or other equipment?

YesNo

If yes, please provide details

Line of Business Applications

List required applications here

Printing

Specify a default printer (if known)

System Security

Allow employees to have remote access to email (Outlook Web Access)?

YesNo

Allow employee to have email access on smartphone?

YesNo

Allow employee to have remote desktop access?

YesNo

Additional Information

Specify additional information here

Authorized Administrator

Your Name (required)

Your Email (required)

Remove User

Please complete the following form in its entirety so that we may remove the user from your system.  Please keep in mind that it can take up to 24 hours for your request to be processed. If this request is time sensitive, please complete the form and then contact Support regarding your request.

User Information

Employee's Full Name

Employee's Email Address

Effective Date & Time

User Data Retention

Employee's documents

RetainDelete

Employee's Email

RetainDelete

Forward Email?

YesNo

If yes, forward to which email?

Additional Information

Specify additional information here

Authorized Administrator

Your Name (required)

Your Email (required)

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