Telecommunications Work Request Form

First name

Last name

Campus Address
(Building and Room)

Requestor's Phone Number
(Who we can call with questions)

Email (example: jdoe@kumc.edu)

Department

Department Account # (I.E. University billing # OB894###)

Location of where work is to be accomplished:

Building

Room Number

Description of work needed. Please provide as much detail as possible
such as existing Jack ID#'s, phone features requested and phone numbers
for each line to be worked on:

Provide a cost estimate for the above work?

yes
no

Contact information

All voice and data work orders should be requested via e-mail to: telecom_workorder@kumc.edu; include your name and telephone number and a representative will contact you for details.

Dave Schleztbaum, Equipment Planning Technician
dschletzbaum@kumc.edu
913-588-4932

Dick Campbell, Equipment Planning Technician
dcampbell@kumc.edu
913-588-4922

2003 Wahl Annex
3901 Rainbow Boulevard
Kansas City, KS 66160-7171