Prairie View A&M University
Phone Service Request
DATE:
All requests for new phones, deletions, or modifications (including name changes) must be emailed to
Telephone Office at telephone_office@pvamu.edu or sent to WR Banks Room 240 MS 1460
Requester Contact Information
Requested By: ___________________________
Phone Number: ___________________________
E-mail Address: _______________________________
Dept.: ______________________________________
Client Information (person receiving the service)
Location
Name: _________________________________
Phone Number: __________________________
E-mail Address: __________________________
Dept. Head:
Office Location: ______________________________
Bldg: _______________________________________
Dept: _______________________________________
Account Information: _____________________
Dept. Head :
Please Print
Date:
(Signature Mandatory)
New Service
Type of Phone
Select the appropriate phone
Will the client need a long distance code?
Yes
Change in Service
Is this a change in existing service?
Number on the phone to be changed?
Name currently:
Supply the appropriate answer
Yes
No
7821 - $180.00
7965 - $ 360.00
7962 - $360.00
7975 - $425.00
No
New name:
Check needed services.
Voicemail
Department Menu
Is this a physical removal or deletion of service
Removal
Move
Is this a physical phone change?
Select or fill in the appropriate answer
Yes
No
Where will the client be moving to?
Deletion
Office Location: ___________________
Bldg.: __________________________
Dept.: __________________________
For all Other Phone Requests: (Be specific) (programming, phone type needs, services)
Phone Office Tracking Information
Approved By:
Date Approved:
ITS Tracking Information
Date Opened:
Date Closed:
Opened By:
Closed By:
Assigned Extension:
Phone Mac Address:
Updated 2/04/2016
Active Directory:
Auto Attendant:
Phone Serial:
Email:
Phone System: