Shared Mailbox Account Application Form
Application Type
New account Renew existing account
Specify email alias(s)
Preferred Display Name of Shared
Mailbox (if new account)
Account Manager Details
Email address
Internal address for correspondence
Internal Telephone Number
Full Delegation to Shared Mailbox
Send As Rights to Staff
Permissions Set by Administrator
Staff for Delegation Details (only if ticked “Full Delegation to Shared Mailbox”)
Staff Member Email
Staff Member Email
Staff Member Email
Staff Member Email
Staff Member Email
I have read and agree to abide by the University's Acceptable Use Policy
I understand that the system administrator may at times have to take appropriate
actions which may affect my work in order to maintain a properly functioning
Signature of Account Manager
Account Length
There are two types of account depending on whether you are being sponsored by a JCU
organisation or by an affiliated organisation. Please choose the appropriate type below:
Type 1 - JCU organisation
Number of years account required
Type 2 - Affiliated organisation
Number of years account required
Affiliated types
Queensland Parallel Supercomputing Foundation (QPSF) Member
Student Association member
College or Halls of Residence staff member
Other affiliated organisation
Authorisation Details
Name of authorising department
Email address of person authorising
Telephone number of person
Signature of person authorising
1 Year
1 Year
Submit Form
click to sign
click to edit
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