Please print out and complete this form, than fax it to 780-4933 or mail to
Telecommunications Department (4 Payson Smith Hall).

University of Southern Maine
Calling Card Form

Department: _________________________________________________________________________


Contact Person: ________________________________________ Phone: ________________________

*PeopleSoft  Chart Fields
 
Dept. ID # Acct #  Fund # Program/Project #

___│___│___│___│___│___│ ___

 6│ 4│ 0│ 0│0 

 ___│___

 __│___│___│___│___│___│ ___

Calling Card:

● ADD* ____     ● DELETE* ____

* Please submit a separate form for each request.

Name: ____________________________________________

Ext. #___│___│___│___│

Address (Bldg, Campus etc.): ________________________________________________________
Address: _________________________________________________________________________


Authorized by: _______________________________     Signature: ___________________________

Date: ___│___│___

rev 8/06