CALLING CARD REQUEST FORM

Requests for AT&T Federal Calling Cards should be made by faxing this form, completed and

signed to 865-241-6782 or by completing the Online Calling Card Request Form

1. DTC Name & Telephone Number:

2. Customer’s Name:

3. Badge Number:

4. Telephone Number:

5. Building and Room Number:

6. Mail Stop:

7. Charge Code:

How to obtain Calling Cards

1. Pick up at Service Order Center 9702-1, Room 231.	· The cardholder must sign this completed form at the time the card is picked up. · Service Center Personnel are available Monday - Friday from 7:00am to 5:00pm. · Calling cards picked up at the Service Center require a four-hour notification.
2. Delivery by plant mail. The card will be issued when all items 1 thru 7 above are received.	· Qwest will complete this form and enclose with the card when mailed to the customer. · This form must be returned signed within thirty days. · The original copy should be mailed/faxed to: Qwest Customer Services 9702-1 MS 8025 room 231 Phone Number: 865-576-3663 Fax Number: 865-241-6782 If you no longer have a need for the card, please return it to the address above.

Guidelines for Telephone Calling Card Usage

· Telephone Calling Cards are to be used for Official Business Calls Only.

· Telephone Calling Card security is the responsibility of the employee issued the card.

· Loss or Theft of the Telephone Calling Card should be reported to Qwest Customer Services at (865) 576-3663 immediately. A new calling card will be issued.

For more information on AT&T Calling Card services, visit http://www.att.com/traveler/tools/.

I understand and comply with the Guidelines for Telephone Calling Card usage.

Cardholder Name:

Cardholder Signature:

Calling Card Number:

Issue Date: