Request for Cellular Phone and/or Pager

Please fill this form out completely, print it, and return in hard-copy format to the Communications and Network Services Department with your division's vice president's approval and signature. Upon receipt of your request, a member of the Telecommunications Department will contact you with information regarding various contract plans and rates.

Please provide the following contact information:

Name

Department

Extension

E-mail

No. of Cellular Phones Requested

Phones to be assigned to:

(employee name)

No. of Pagers Requested

Pagers/type to be assigned to:

(name) Alpha Digital

Account Number to be charged for service

(When form is complete, print it using File, Print from top menu bar.)

Vice President's Signature

__________________________________________