Smartphone Service Form

Use this form to request new smartphone service or upgrades to existing smartphone service. IR&C users must review and sign the Portable Electronic Device Usage Agreement (pdf) and submit it to TechDesk, 7th Fl. Franklin.

For Transfer of Liability, Local Port, orders for Accessories or Account/Feature Changes, please use the Other Smartphone Services Form.

All fields are required for this order to be processed.

Indicate Order Type New Service/Equipment Upgrade Equipment

Requestor/User Information

Requestor's Name:
Requestor's Phone:

User's Name:
User's Department:
User's Office Phone:
User's Smartphone No.:
User's Smartphone Account No:

(Existing smartphone number required for upgrade, local port, transfer of liability, warranty exchange, account/feature changes, and deactivations.)

Smartphone Services Requested

Select Blackberry or iPhone (see available supported models), and complete the corresponding section.

Blackberry
Model:
Select Carrier:
Provide desired area code:

* Request # of call minutes:
Text messaging: Yes No
* If yes, select amount:

iPhone
Choose Capacity: 16GB 32GB
AT&T Verizon
Provide desired area code:

* Request # of call minutes:
Text messaging: Yes No
* If yes, select amount:

* See rate plans (pdf) for options on # of call minutes and text messaging.
* Data plan: E-mail is included with every order at an additional cost as listed in the rate plans (pdf).

AUTHORIZATION OF CHARGES FOR SMARTPHONE ORDER

FAU to be charged: Loc: M Account: Fund: Sub:
Department Code:

Manager with Signature Authority:
Name:
E-mail:

Print, Submit, or Cancel

Use of UCOP electronic communications resources must conform with the UCOP User Agreement, the UCOP Acceptable Use Policy, and the University of California Electronic Communications Policy.
You may print this form for your records prior to submitting.

Please submit your questions, comments, and suggestions at feedback.html