Telephone Request Form

Please allow 2-3 business days for processing.

Complete this form to have any work done on the phone: installs, moves, name changes, etc. If you desire a larger phone, it must be purchased at your department's expense through IT Purchasing.

Select building that needs the installation/change:	Administration Building Classroom Building Communication Building Library Building Metroplex 1 Regent Commons Regent Village Robertson Hall Student Center
First & Last Name of person completing form:
Email Address:
Current Cost Center:
Department Name:
Department Manager:
Extension of phone to be worked on
Current Name on Extension:
Exact Room # of Extension:
Mail Drop Address:
Current Phone Type:	Click here for more information.
Type of Service Requested:	New Install (is there an available jack on the wall?) Upgrade
Type desired for upgrade or new install:	Click here for more information.
Program Buttons*	Yes No
Move:	Yes No
Move To:
Remove:	Yes No
Effective date:
Change Cost Center:
Change Name To:
Change Mail Drop:

Issue New Long Distance Code:	Yes No
Voice Mail:	Activate Remove Reset
Calling Card:	Issue One Continental International Cancel
*For information about Program Buttons, contact the Help Desk at x4076.
Additional Comments: Please include any additional details to assist us with fulfilling your request:

Regent University - Christian Leadership to Change the World

Telephone Request Form