Long Distance Authorization Code Request

*Full Name:

*College ID Number:

*E-mail:

By submitting this form, you are officially submitting a request for a long distance authorization code. This code must be kept confidential. If you lose or misplace it -- or believe that it has been compromised -- please call the Telecommunications Office at extension 7171 IMMEDIATELY. You will receive an e-mail containing your personal long distance authorization code once the code has been activated.