Cellular and Wireless Services Order Contact InformationName* First Last Campus Unit* Department, Division, School or CollegeEmail* Phone*User InformationName* First Last Email* Phone*UBR/Billing informationUBR Name* First Last UBR Email* View a UBR list A UBR must authorize purchase.Full Funding String (UDDS)* Enter the fund, organization, and activity/program numbersProject Number Type of Service/Request*Select One...Aircard/Wireless ModemApple iPad OrderCellular Change PlanCellular Phone DisconnectNew Cellular Service AuthorizationOther/Funding ChangeApple iPad Order InformationPlease Describe:*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Delivery Instructions:*Justification for iPad Purchase*Date Needed* MM slash DD slash YYYY Aircard/Wireless Modem Order InformationPlease Describe:Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Delivery Instructions:*Justification for Aircard/Wireless Modem Purchase*Date Needed* MM slash DD slash YYYY Cellular Change Plan RequestPhone Number*Current cellular plan* New cellular plan request* Reason for Request*Telecommunications staff will review and determine if desired plan is appropriate. If the plan is approved, a notification will be sent to you and your UBR(Unit Business Representative). Note: There is no penalty or charge to charge plans other than the change in your monthly service charges. If you have questions, contact Telecommunications at uwm-wireless@uwm.edu or call 414-229-5383.Cellular Phone Disconnect RequestCell Phone Number*Disconnect Date* MM slash DD slash YYYY New Cellular Service Authorization RequestThe UWM U.S. Cellular Authorization Request includes information required under the state of Wisconsin Enterprise Policy on Cellular Telephone Services and Equipment. School/College/Division authorization has also been incorporated into the ordering process. This online order form will be transmitted to your Unit Business Representative (UBR) at the same time it is sent to UITS. UITS will log your order and will place the final order once the authorization is provided by your UBR. If you have questions about the information required on the form or the authorization process, contact your UBR, or Telecommunications staff at uwm-wireless@uwm.edu or by phone 414-229-5383.Order Item*New Digital Cellular Airtime ServiceChange/Upgrade Existing Service or EquipmentCurrent Cell Phone Number*Service Plan*Flip Phone - $5 a month plus usageOtherIf Other: Please provide further detail:*Note: If other service plan is needed, please contact uwm-wireless@uwm.edu for additional plans available.Type of Equipment*FreeOtherIf Other: Please provide further detail*Do you want voice mail on the cellular phone?* Yes No Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date Needed* MM slash DD slash YYYY Please allow at least one week for order and delivery.Initial* I have read and understand the terms in the policy for state cellular use and will provide a signed cellular policy acknowledgment form to my UBR (Unit Business Representative).Other/Funding ChangePlease Describe: