Western Mindanao State University Western Mindanao State University

Management Information System & Technology Office Management Information System & Technology Office
Zamboanga City Zamboanga City

WMSU ACCOUNT REQUEST FORM WMSU ACCOUNT REQUEST FORM

Control No. 2019- . Control No. 2019- .
DATE REQUESTED (MM/DD/YYYY):___________________ DATE REQUESTED (MM/DD/YYYY):___________________
Please select from the following accounts: Please select from the following accounts:
TYPE OF ACCOUNT: myWMSU Portal WMSU Email Office Email TYPE OF ACCOUNT: myWMSU Portal WMSU Email Office Email

Employee|Student Number: ____________________ Employee|Student Number: ____________________

NAME of Employee|Student: ________________________________________ NAME of Employee|Student: ________________________________________
Last Name, First Name Middle Initial Last Name, First Name Middle Initial

College|Unit: ___________________________________________________________ College|Unit: ___________________________________________________________

Mobile Number: __________________ Email Address: _____________________ Mobile Number: __________________ Email Address: _____________________
Signature: _____________________ Signature: _____________________

PRIVACY NOTICE: Your data will only be accessible to MISTO personnel for the sole PRIVACY NOTICE: Your data will only be accessible to MISTO personnel for the sole
purpose of creating an account. You can contact us for modifications and purpose of creating an account. You can contact us for modifications and
corrections to the data. corrections to the data.

Password and/or account details will be sent on the provided email address. Please Password and/or account details will be sent on the provided email address. Please
attach a photocopy of your WMSU ID to this request form. attach a photocopy of your WMSU ID to this request form.
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ITEMS BELOW THIS LINE TO BE FILLED UP BY MISTO STAFF ITEMS BELOW THIS LINE TO BE FILLED UP BY MISTO STAFF
Received by: Received by:
_______________________________ _______________________________
Processed by: Processed By:
_______________________________ _______________________________
Date Processed: Date Processed:
_______________________________ _______________________________

WMSU-MISTO-FR-001 Effective Date: 01-JAN-2019 WMSU-MISTO-FR-001 Effective Date: 01-JAN-2019