Physics Computer Services

New Phone Instrument Request Form

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Please expect a 2-3 day turnaround, especially during peak periods.
Call us at x8366 if it is an emergency.

Please review the Physics Department Phone Charges information to determine the level of service desired, and review the fee structure.

Basic Information
Name of person requesting phone :
Phone number of person requesting phone :
E-mail address of person requesting phone :
Name of principal investigator associated with this phone :
Phone of principal investigator associated with this phone :
Name as it should appear in the department directory for this phone :

Instrument Location Note, not all locations are supported.
Building:	Choose one Building 328 (Grad Trailer) Building 572 North Wing (Broida Hall, 4 story side) Building 572 South Wing (Broida Hall, 6 story side) Building 672 (Physical Sciences South) Building 937 (OT-1 trailer) Building 939 (OT-2 trailer) Building 942 (OT-3 trailer) Other (explain in comments section)
Room number :
Wallport number (see wallplate): examples include 5227 N1, 1322 S1, 1001-1, 110C or 107E
Phone jack to use: DO NOT specify a jack already in use!	Choose one V1 D1 D2

Service Type
Type of service requested: See definitions for more information.		Choose one Transfer existing analog phone number (specify number below) New phone number with toll-access New phone number with no access to toll calls Internal (intradepartment) extension, no external access (rare) Internal extension, ringing existing VoIP number
If transferring or ringing an existing number: First phone number: 893-
If also ringing an additional existing VoIP number: Second phone number: 893-
If also ringing an additional existing VoIP number: Third phone number: 893-
Will this extension need voicemail:		Choose one Yes No
If you wish voicemail to be e-mailed also, please specify e-mail address:
If this extension receives a Fax, please specify e-mail address:

Billing Information
Specify the account number to charge for non-recurring charges (i.e. toll calls) in the UC location-account-fund-sub format, for example: 8-886455-12341-3
Account:		8 Q - - -
Do you believe the department will be paying for the recurring charges at this instrument? See the department policies		Choose one Yes No - bill the same account as for non-recurring charges
Comments:

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