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Request for Wireless Device for MPP |
| EMPLOYEE NAME: | EMPLOYEE ID: | ||
| DEPARTMENT: | EXTENSION: |
Information on devices and service plans under contract can be obtained by contacting Purchasing and Contract Administration at ext. 2301. Complete this request, obtain approval and forward this form to Purchasing and Contract Administration. The device and/or service will be procured and the employee will be notified to pick up the device from Purchasing and Contract Administration. The undersigned employee will be issued a wireless device/service in accordance with Acquisition and Use of Portable Communication Equipment and Related Services for MPP, Confidential and Auxiliary Employees Policy 900-16 (http://www-admn.csun.edu/vp/policies/900_oversight/900_16.htm) The undersigned employee has read the policy and agrees to abide by the policy and the accompanying procedures located at (http://www-admn.csun.edu/vp/policies/900_oversight/900_16_procedures.htm), Acknowledgment: |
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| EMPLOYEE SIGNATURE: __________________________________________ |
DATE: _____________ |
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| This is a: | NEW REQUEST | REPLACEMENT REQUEST | TRANSFER REQUEST |
| Check one of the following: |
| CELLULAR TELEPHONE / PDA / SMARTPHONE | WIRELESS CARD | PAGER | |||
| MFGR: (EX: BLACKBERRY, PALM, TREO) | |||||
MODEL #: (EX: 8830,755P) |
COST: $ | ||||
| Service Plan: | MONTHLY COST: $ | # OF MINUTES: | |||
| Type of Plan: |
(Provide the Name of the PLAN PROVIDER and the NAME of the PLAN.) |
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| Approval: | |||||
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REQUIRED
FIELDS:
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ACCOUNT:
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FUND:
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DEPT
ID:
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PRGM:
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CLASS:
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PROJECT/GRANT:
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REQ
#:
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| Review &
Approval for Chartfields: |
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| FINANCIAL MANAGER SIGNATURE:________________________________________ |
DATE:
_____________ |
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~ Purchasing Department Only ~
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| TELEPHONE NUMBER: _____________________ | REVIEWED BY: __________________________ |
| . | PURCHASING & CONTRACT ADMINISTRATION |