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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


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Updated: 6/28/2007