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Move and Change Existing Service

*Required

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

(Change 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:
Subscriber's E-Mail:

Current Telephone Information

Telephone Number: *
Building Name *
Room Number *
Jack Number * If unknown, type N/A

New Location

Building Name *
Room Number *
Jack Number * ** If a New Jack is required please type in NEW and a site survey will be performed. For existing jacks the Jack Number is required.

Choose TYPE of SET:

SINGLE LINE SET Desk
Wall
Speaker Phone
Speaker Phone w/ Caller ID
MULTILINE SET 10 Button
24 Button
LINE ONLY: (No phone set) Modem
Fax
Secondary
Call Forward Remote
Other: (Please Specify)

Select ONLY the features you want to change:

If you already have a feature, you do not need to specify it below unless you want it changed.

Campus Calling  Only
Campus and Local Calling Only
Campus, Local and CT Calling Only
Campus, Local, CT and Out of State Calling Only 
Campus, Local, CT, Out of State, and International Calling Only
Campus Only after 4:30PM
Voice Mail - If you select voicemail, please insure subscriber information is filled out completely.
      Call Forwarding: No pickup forwarded to:
      Call Forwarding: Busy Line forwarded to:
Voice Mail Notification (Branches Only):  Audible (Stutter)  Visual (Msg Light) Both (Audible & Visual)
2-Digit Speed Calling
Call Pickup (List other extensions):

Other Hardware:

6' Mounting Cord is standard.

Single Line Analog Set 12' Handset Cord ( $7.15 )
14' Mounting Cord ( $2.05 )
25' Mounting Cord ( $4.10 )
Multi-Line ISDN Set 12' Handset Cord ( $7.15 )
14' Mounting Cord ( $12.25 )
25' Mounting Cord ( $14.30 )

MULTI-LINE SET BUTTON ASSIGNMENTS

For larger sets, please specify any additional configuration in the comments field
Specify Ring Pattern: R=Ring, DR=Delay Ring, NR=No Ring

Change Button Assignment to:
Current Button Configuration
 | New Button Request
A = 
R | A =  R
B = 
R  | B =  R  Outgoing calls only, unless specified to ring
C = 
R  DR  NR | C =  R  DR  NR
D = 
R  DR  NR  | D =  R  DR  NR 
E = 
R  DR  NR | E =  R  DR  NR
F = 
R  DR  NR | F =  R  DR  NR
G = 
R  DR  NR | G =  R  DR  NR
H = 
R  DR  NR | H =  R  DR  NR
I =  Auto Callback Calling
 | I =  Auto Callback Calling
J =  Call Forwarding Variable
 | J =  Call Forwarding Variable

Comments:



Please physically take the current phone to the new location.


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Updated: 9/28/2009