Carroll County IT Department
605 Pine Street
Hillsville, VA 24343
276.730.3000 ext. 3186 or 3187

NEW carrollcountyva.org EMAIL ACCOUNT Request Form

Please fill out all blocks on this form and make sure and click submit to finalize the request.

* First Name

* Last Name

* Department

* Phone Number

* Current Email Address:

* REQUESTED carrollcountyva.org Email Address:

The standardized format is first initial and last name (example: jdoe@carrollcountyvaorg) unless already taken

Additional Information if necessary

You will receive confirmation when the requested email address has been set up.

Contact the IT Department if you have any questions or concerns!

* Indicates Response Required