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OREGON STATE UNIVERSITY

TELECOMMUNICATIONS



REQUEST FOR TELEPHONE CHANGE



Mail one (1) copy to: Telecommunications Services

KAd A010

Customer Service 3-3440





Date



Department



Telephone Coord.



Coordinator Ext.



FIS Index Number for Installation or One Time Charges



Brief Description of Request (please include building name and room numbers; include a map showing all

additions and moves):









(Note: For Staff Directory changes E-mail Patty Zetzman at patty.zetzman@oregonstate.edu or call 7-7878.)



Requested Completion Date: Work sooner if possible? Yes / No







Authorized Signature:







Telecommunication Services 3-06


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