Request for Telephone and/or Computer Service for New Employees and/or Relocating Employees

Communications and Network Services Department staff will relocate telephone/computer equipment only. Please print this form and return it in HARD-COPY format to the CNS/Telecommunications Department with a department head approval and signature. Please submit 10 business days prior to any anticipated need. (If you have questions regarding form please call the CNS / Telecom ext. 2076)

Please select which applies to this Request for Telephone/PC Service

Office Move New Employee Department Change

Contact Person:		Extension:
Department:		Account No.
Employee Name		Extension:

Use this section for Office Move

Current office: Bldg. / Room #		New Office: Bldg. / Room #
(i.e. bldg/ rm # 5 - 103)		(i.e. bldg/ rm # 5 - 103)

Date move is scheduled to take place:
	(REQUIRES 10 DAYS NOTICE)

Please check all equipment choices that apply to the move:

Telephone & Computer Local Printer Network Printer Scanner

Use this section for New Employee or Department Change

Please check all that applies and fill in where information is needed:

New MCC Employee Employee Changing Department

Relocate from Damon to Brighton Relocate from Brighton to Damon

Does Department affiliation need to be changed?
If yes New Department Name

Reassign Extension Assign new Extension

Full-time Part-time Adjunct

Bldg. / Room #

(i.e. bldg/ rm # 5 - 103)

Date Service is needed

(REQUIRES 10 DAYS NOTICE)

Do you want Voice Mail on telephone? Yes No

Type of calling: Local Long distance Internal calls only

Is there a computer in the office? Yes - Provide decal number
No
PLEASE NOTE: If one is needed, Department must request a Cascaded PC from Bob Cunningham

Will you need CNS to rebuild computer for new employee? Yes No

In the box below please write in any additional information that would be helpful to the CNS staff for processing your request:

When form is completely filled in, print it using File, Print off the menu bar at the top. The form should then be forwarded to your department head for signature and mailed to CNS/Telecommunications Department.

Signature of Department Head:

_______________________________________