Telephone Service Request Form & Instructions

Networking & Telecommunications Services
Telephone Service Request (TSR)
1. Department / PS Account To Be Charged: 2. Individual To Whom Phone Is Assigned:
3. Building & Room Number Needing Service:
4. Contact Person: 5. Telephone No: 6. Desired Completion Date:
7. Service Required:
Install New Analog Line Install New Digital Line
On Campus Access Only Campus / Local Access Campus, Local, and Long Distance
Voice Mail
Call Forward Variable
Call Forward When Busy -- To What Number?
Call Forward When No Answer -- To What Number?
Move Line # From To
Move Line # From To
Delete Line #
8. Individual Requesting Change / Date: 9. Department Head Signature / Date:
10. Director Of Networking & Telecommuncations / Date:
11. Work Order Number: 12. Heat Ticket Number:
Additional Comments:
Move Line # From To
Move Line # From To
Return signed form to Office of Networking & Telecommunications or FAX: 301-687-3200

INSTRUCTIONS FOR USE OF TSR FORM
This form is required to be used whenever the following telephone related items are requested:
- Addition of a new telephone line
- Moving an existing line from one location to another
- Changing an existing line from an analog line to a digital line or vice versa
- Modifying the ‘dial out’ features of an existing line
- Deletion of an existing line
This new form will allow you to fill out the form on-line, print it and then submit it, via campus mail or FAX, to
the Office of Networking & Telecommunications. The reason it cannot be submitted electronically is because it
requires a signature from the Department Head of the department making the request. Once you exit the form,
all data is cleared and the form is ready to be used again next time.
Using the form is very simple:
- Double click on the form to open it.
- Across the top you should see a check box. Check the box to highlight the fields that are required to
be filled in by you.
- Fill in all required fields.
- Click on the ‘Print’ button in the top right corner of the form. Print two copies if you wish to maintain a
copy for yourself.
- Have appropriate individual sign the form at line # 9 and mail or FAX (3200) the form to Networking &
Telecommunications.
Any questions or problems please contact the Office of Networking & Telecomunications at 4317.