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Information Technology Services

10000

Mobile Phone Request Form

Mobile Phone Request Form

Mobile Phone Request Form

Name:_________________________________________________

Department:____________________________________________

Justification for Phone:________________________________________________

Approvals

 Requester:____________________________________________

 Date: ____________

Department

 Vice President/Dean:_____________________________________

 Date: ____________

 Budget Account#: _________________
(Code 6339 for Equipment purchase), (Code 6441 for monthly usage)

Telecommunications Department

 Director:___________________________________Date:_______

 Equipment Assigned: ___________________________________

 Mobile#__________________ Contract term:_________________

 

Please print, fill out the form and forward it to Patricia Druid, Director of Telecommunications at druidp@merrimack.edu or stop by the IT Department on the 2nd floor of the McQuade building.