Request Ethernet Service Disconnection

Please complete the following form or email itmac@ku.edu with your request.

* indicates required information
*Contact Person:
*E-mail Address:
*Contact Phone Number: --
*Department:
*Fiscal Authorization Contact:
OR if either are NOT listed:
Department:
Fiscal Authorization Contact:
*Building:
OR Other:
*Room:
*Existing Data Circuit #:
Requested Completion Date:  , 
If IT scheduling allows, is there a specific date you would like this work performed?
*Installation Account:
Org + Fund #
Work Order Information
*Building / Room #:
Jack Number (if existing):
(ie 1-1A-125-1Y)
Circuit Number:
(ie 9-1201 or 6-1234)
Additional Information/Comments