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Telephone Authorization Codes Form

The following form is used to request, deactivate or transfer Long Distance Authorization Codes.  If you experience problems or have any questions, please contact Jennifer Fluckiger by phone at 435-797-0021,  email at Jennifer.Fluckiger@usu.edu or contact the IT Service Desk at 435-797-4357(HELP).

Department: :
UMC: :
Contact 1: Name :
Contact 1: Phone :
Contact 1: Email :
Contact 2: Name :
Contact 2: Phone :
Contact 2: Email :
Who should the Auth Code be sent to? :
If "Another Person" was selected above, please provide the Name and UMC of the person you want to receive the Auth Code.
Another Person :
If you wish to ACTIVATE a new long distance authorization code, please check the box and fill in the corresponding fields below.
Name: :
Phone: :
Banner Index Number: :
Department: :
UMC: :
If you want to DEACTIVATE a long distance authorization code, please check this box and fill in the corresponding fields below.
Name: :
Phone: :
Auth Code: :
If you want to MOVE a long distance authorization code from one individual to another, please check this box and fill out the corresponding fields below.
From User: :
From Phone: :
Auth Code: :
To Phone: :
To User: :
Account: :
Comments: :
If you have any comments or special instructions for this request form, please enter them here. The person receiving the request will review them.
Validation :

(Please enter the letters and numbers that appear below)
   



Utah State University Information Technology