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Cellular Phone Request Form

Order of Saint Benedict

Cellular Phone Request Form

Date______________

Name:____________________________________

Department:_______________________________                                                                        

Title:_____________________________________                                                            

Office Phone Number:______________________                                                            

Account Number:__________________________

Please describe the need for a cellular phone.  Provide details of how the phone will be used to benefit your work and department:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Provide an estimate of monthly usage in minutes and describe the basis for your estimation:

______ minutes per month      basis for estimation:________________________

__________________________________________________________________

Provide the range of use required for this cellular phone.  Indicate which areas will have monthly usage:

Local_____Mpls/St. Paul_____Regional (5 state area)_____National_____

Person Requesting Cellular Phone

I certify the above to be an accurate reflection of my business needs and monthly usage.  I have read the Order of Saint Benedict Cellular Phone Policy and agree to comply with the requirements.

 

______________________________                        Date______________

Requester’s Signature

Supervisor

I approve the above request for a cellular phone.  The use and estimated monthly minutes accurately reflect the requestor’s business needs.  The account number listed has funds available and is appropriate to use for this expense.  I have read the Order of Saint Benedict Cellular Phone Policy and agree to comply with the requirements.

 

______________________________                         Date______________

Supervisor’s Signature