Site Survey Form

Telecommunications Department

Hours of Operation 8 am-4:30 pm, Monday-Friday.

*Summer/Winter break hours are 8:00 am - 4:00 pm

Telecommunications Site Survey Form

Contact Information
Name:	Telephone #:	Email:
*	*	*
Please select your department or enter your company name.
Department *	Other	Company Name
		*

Detailed Description
Please provide a detailed description of what you are hoping to accomplish. Include building names, room numbers and telephone numbers (if they are existing) in your description.

Access Restriction
Are there any access restrictions to this space (classes, times when no one is available to let us in the room to check it out)? If so, please provide a list of dates/days/times when we will be able to get into the space to survey it..

Once we complete the site survey, we will get back to you with an estimate of the cost and a proposed time schedule. If you decide to go ahead with the project, please fill in the appropriate work requests on the Telecommunications web page.

If you have any questions about filling in this form, please contact us at x5151, option 2 and we will be happy to assist you.

If you would like a copy of this request for your records, please print this page before you submit the form. Use the print button below.

* Required Information: This form can not be submitted without the required information.