Contact Information:

Contact Person:

Contact Phone:

Email Address:

Department:   

Campus/Location:   Please Select CYP ELG EVC FBG HAYS HBC NRG PIN RGC RRC RVS SVC SAC SMC

Name of person who will use this new phone line (if different from contact person):

Account Information:

GL Account #:

Phone Line Information:

Building/Room #:   Jack #:

Single-Line Telephone

Multi-Line Telephone (how many lines are needed? _ 2 3 4 5 6 )

Modem

Fax

Other

Phone number(s) of existing lines to appear on multi-line telephone (if applicable):

Additional Features: 

Note: forward and transfer are included

Call Pick Up (list all phone numbers to be picked up: )

Long Distance Deny

Conference (ability to "conference" up to six parties)

Voicemail Name Phone number that caller should reach if they hit zero while in voicemail (optional):

Comments: