RESIDENCE SERVICES
Local Phone Service Request for Student Rooms
I am requesting that you activate the phone line in my room. I understand that my student
account will be billed a $65 activation fee for the initial setup and $60 per semester charged for
the phone service. I also understand that there will be an additional $65 charge if I move to
another room on campus and choose to bring my phone service with me.
Furthermore, I understand that neither a phone nor voicemail will be provided. I am
responsible to provide my own phone (only touch tone telephones can be used for placing calls)
and if desired my own answering machine. Also, I understand this phone service is for local and
on-campus calling only. If long distance calling is required I will need to make other
arrangements (the use of a calling card for example).
Initial Setup—For Students applying for a land line phone
Student Name:
Banner ID:
Hall and Room:
Cell Phone:
* Activate for:  Academic Year
Email:
 Fall Semester Only
 Spring Semester Only
Transfer of Service Request—For Students Changing Rooms and Continuing Phone Service
Student Name:
Old Hall and Room:
Banner ID:
New Hall and Room:
Current On-Campus Phone:
Cell Phone:
Email:
* Activate for:  Academic Year  Fall Semester Only  Spring Semester Only  Summer
Student Signature:
Date:
* Note: Activation fees are non-refundable once service is activated. Also, service charges are
non-refundable unless de-activated before the start of the semester
For Office Use Only
Activation Date:
Deactivation Date:
 Initial Setup Fee ($65)
 Per Semester Service Charge ($60) X
semesters
 Transfer of Services Setup Fee ($65) X
room changes
Total Charges: