RTS: Our Priority is getting you connected


Communication and Network Services
2484 Shattuck Avenue
Berkeley, CA   94720-1640
Service Agreement
Phone:   510-643-7000
FAX:      510-643-7046
Email:    rts@berkeley.edu
Residence Telephone Services

Name: 

SID #: 

E-mail Address: 

Residence Hall: 

Room #: 

Telephone: 

Off-Campus Address: 

City: 

State: 

Zip: 

Country: 

Off-Campus Telephone: 


I have read and understand the UC Berkeley Residence Telephone Services Terms and Conditions of Service. I understand and agree that I am responsible for all charges to my extension, including payment for any and all calls or services charged to my extension. I also understand that it is my responsibility to audit my monthly statements for accuracy, and to report any discontinuation of any and all telephone and/or related services.

I fully understand the consequences of not adhering to these outlined and published Terms and Conditions of Services, and accept full responsibility for my actions, these services assigned to my account, and the payment of these services.

Residents must notify Residence Telephone Services in writing of a change in residence hal address or move off campus. Failure to do so will result in your being liable for telephone services charged to your account.

By submitting this form you agree to abide by all the rules and regulations as stated above.

Date:    

                       

You will receive a confirmation of this completed form via e-mail


    Please Note:  Although it is most unlikely that you will experience any problems responding to this form,

    certain non-standard browsers will not respond properly. If you experience any difficulties, or if you are   

    not using a forms capable browser, you may email your responses to: rts@berkeley.edu     

                   

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©1999 The Regents of the University of CaliforniaCopyright©1999 The Regents of the University of California.   Internal Use:   Staff Dir   
       Address comments to: rts@berkeley.edu.
       Revised: January 16, 2004