CELLULAR USAGE AGREEMENT UNIVERSITY PROVIDED
SERVICE DEDICATED DEVICE FOR EMPLOYEE
- Employee Name - Enter the name of the employee requesting a cellular device.
- PSU ID - Enter the employees' PSU ID number.
- Employee Title - Enter the employees' title.
- Email - Enter the employees' email address.
- Department Name - Enter the department name.
- Admin Area - Enter the administrative area of the employee.
- Cell Phone # - Enter the cell phone number (if applicable).
- Categorize the business need for cellular services (check all that apply) - Check any and/or all of the following six options: Check box 1 for frequently engages in work-related travel. Check box 2 for frequently out of office on Penn State business. Check box 3 for member of key personnel needed in the event of an emergency. Check box 4 for position requires work off-site at location(s) with no communication. Check box 5 for works from home for convenience of the University. Check box 6 for other and provide a description.
- Rationale (required) - Provide rationale for business need for cellular services (separate memo may be attached). There are two lines available for this information.
- Services being requested check boxes additional information. There are two options available: check box 1 for a new service request or check box 2 for a continuing service request and proceed to next step.
- Check box 1 for Cellular Phone Service and enter the name of the provider/vendor. If the Other Cellular Services box was checked, describe the services. One line is provided for this information.
- Other Cellular Services provided by: Enter the name of the provided/vendor providing the "other" cellular services. One line is provided for this information.
- Account to be charged for services box - Enter the following information on the appropriate line. Line 1: Enter the Account to be charged for service. Line 2: Estimated cost of monthly service. Line 3: Estimated cost of equipment.
- Employee Signature. Print the completed page. The employee then signs and dates the form.
- Department Head or Supervisor: The Department Head of Supervisor of the employee must approve the form.
- Budget Executive/Financial Officer/Director of Business Services: The Budget Executive and either the Financial Office (University Park) or the Director of Business Services (Non-UP campuses) must sign and date the form.
- Office Use Only: Enter the date service ended and the date equipment returned when applicable.