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Telephone Calling Card Application

*Required Field

General Information

Department Name:	*
Department Number
Monthly FRS Code:	*
UCONN Branch:
Department Head's Name:
Has the department head authorized this request?	*	(Please type YES or NO)

Contact's Name:	*
Contact's Telephone #:	*
Contact's E-mail:	*

Subscriber's Name: Name on the phone bill:	*	First: Last:
Telephone Number:	*
Subscriber's E-Mail:

Select one of the following plans:

Plan #3	Domestic, Canada, Puerto Rico, US Virgin Islands and International with the exception of the countries listed: Algeria, Bolivia, China, Dom Rep, Ecuador, El Salvador, Ethiopia, Gambia, Guatemala, Guinea, Honduras, Ivory Coast, Jamaica, Lebanon, Mexico, Morocco, Nicaragua, Pakistan, Senegal and Yemen.
Plan #4	Domestic , Canada , Puerto Rico and US Virgin Islands
Plan #10	Completely unrestricted

Updated: 6/28/2007