Long Distance Access Pin Application printable pdf download

OWARD

NIVERSITY

Request Date: ___________________

Office of Telecommunication Services

Request Type:

Telephone: (202) 806-2955 • Fax (202) 806-5960

___ Domestic

___ International

Long Distance Access PIN Application

Last Name: _____________________________

First Name: ___________________________ MI: ___

Division: _______________________________

Department: ___________________________________

Employee ID: ______________________

Email Address: _________________________________

Employee Telephone Number: _____________ Applicant’s Job Title: __________________________________

Please Read Carefully



Long distance calls made with a Howard University long distance access PIN are for University business only.



The Long Distance Access PIN is non-transferable. Transferring a PIN to another employee will result in

deactivation of the code.



The Long Distance Access PIN is confidential and is not to be shared. It is the responsibility of the PIN holder

to ensure the privacy of the PIN.



Long Distance Access PIN holders will be held personally responsible and financially liable for all

unauthorized calls made using the assigned PIN.



The PIN holder is responsible for ALL calls placed with their PIN. If you suspect unauthorized usage of a PIN,

you must contact the Office of Telecommunications Services (806-2955) to deactivate the PIN.

I certify I have read and understand the above University policy and will be responsible for use and protection of

the Long Distance Access PIN.

Applicant Signature: _______________________________________________ Date: ____________

Grant Period:

Department ID # __________________ Project ID # ____________________

From: ____/______/______

Account # ____________ Fund # __________ Program # _____________

To:

____/______/______

If this ID # is associated with a Grant, please fill in the Grant period.

(At the end of the grant period, the administrator must provide a new grant end-date

or a new Project ID account number.)



Information Systems and Services will continually audit the usage of access codes. In cases where usage

exceeds reasonable expectations, the codes may be deactivated without notice. In cases where abuse is

found, the PIN holder and/or the departmental account will be charged for the associated expense and

disciplinary action will be considered.



A written justification, signed by the applicant and the authorizing official, must be included with this application

for Faculty or Staff who are required to dial International long distance access calls.



Departments should notify the Office of Telecommunication Services (806-2955) immediately when an

employee leaves the University or moves to a different department.

Authorized by: _________________________ Title: ________________________

Date: __________

Email Address: _________________________ Telephone Number: __________________________

OWARD

NIVERSITY

Enterprise Technology Services (ETS)

Telecommunications Services

2301 Georgia Avenue, NW, Suite 201

Washington, DC 20059

Long Distance Access Pin Application

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