SFSU Telephone Work Request - Disconnect Service

TELEPHONE WORK REQUEST - Disconnect Service

Please complete the following form to request a disconnect.
All required fields are indicated by an *. This form is for use by SFSU Unit Telecommunications Coordinators(UTC).

Note: Complete a separate work request for each phone extension.

College/Department Information

*College/Department:
*Contact Person Name:
	*Extension:
	* Email: (Please provide a complete email address - Example: doit@sfsu.edu)

*Authorized by (Name):
	*Extension:
	*Email: (Please provide a complete email address - Example: doit@sfsu.edu)

*User's Name:
	cc Email: (Please provide a complete email address(es) and separate by "," - Example: doit@sfsu.edu, telecom@sfsu.edu)

Disconnect Information

*Extension:

*Disconnect Date:

Building:

Room:

Jack #:

Special Instructions

If disconnected extension appears on other multi-line sets as a secondary line, list extension numbers for those sets

Last Modified: 3 May 2002
doit@sfsu.edu

Disconnect Information
*Extension:
*Disconnect Date:
Building:
Room:
Jack #:
Special Instructions
If disconnected extension appears on other multi-line sets as a secondary line, list extension numbers for those sets