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New Cellular Service Request Form

Cellular phones for departmental use can be purchased from the State of Georgia contract from a list of approved vendors. Information showing cellular models and features, accessory lists, and package plan can be obtained by emailing Shawn Gibbons at sgibbons@valdosta.edu or 333-5706. To take advantage of the State contract's discounted pricing, the Cellular Service Forms must be used.

Faculty and staff may use this form to request new service for departmental cellular phones. An email to the Dean or Department Head will be sent for verification for financial reasons. Processing of this request will begin once email authorization is received from the Dean or Department Head.

Please make certain that you are aware of the pricing for the services you are ordering. You may request a copy of cellular pricing information via email.

Email sgibbons@valdosta.edu any questions pertaining to the use of this form or other service ordering questions.

* Denotes required field.

*Name of department to bill service to:
*Departmental account# to bill service to: (ex. From the 771300 Account)
*First name of new cellular account user:
*Last name of new cellular account user:
*VSU email address of new cellular account user:
*Make of new cellular phone: (ex. LG, Motorola, etc.)
*Model of new cellular phone: (ex. Ax145, Blackberry 8703e, etc.)
  Accessories needed for new phone: (ex. Car Charger)
*Purchase cost of new cellular phone:
*Dean/Dept. Head's VSU email address:

>> View or Print Wireless Device Guidelines (PDF Format)

*If you have read the above Wireless Device Guidelines and Agree with and Understand all policies
please type I AGREE in the following text box:

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