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Conference Phones and Headset Purchase Requests

For Cellular Telephone Headsets goto: Cellular Telephone Headsets/Accessories

*Required Field

Department and Billing Information

Department Name:	*
Department Number
Monthly FRS Code:	*
One-Time FRS Code:	*
UConn Campus:
Department Head's Name:
Has the department head authorized this request?	*		Approval is required. By indicating "yes", your department agrees to pay for all charges that pertain to this request.

Contact Information

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

Subscriber Information

Fill in this section ONLY if you want to change how the listing appears on the monthly invoice.

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

Accessories

Conference Phones (Polycom)	Price
PolyCom Soundstation-2	$377.30
PolyCom Soundstation-2 Expandable (Microphones sold seperately)	$544.50
2 External microphones	$159.50 /set	How many sets of 2?
The Konference phone adapter (To use a conference phone on an ISDN telephone set.)	$130.90

Comments:

Updated: 6/28/2007