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Network Services Enterprise (NSE) — Request for Road Runner High Speed Online Service

Please note: This form will request a new high speed data line and make you responsible for any installation fees, as well as the monthly service costs. This form applies if you have bought a cablemodem.

*Please provide the following information: (an denotes required fields)**
First name:	*
Last name:	*
Current telephone number where we can contact you or leave a message:	*	Please include area code.
Service address where the high speed data is to be installed:	*	Note: Must be within Time Warner Cable's Oxford service area.
Room or apartment number:
Your e-mail address where you can be contacted:	*
I am		a Student (charges will be billed through the Bursar) Faculty / Staff (charges will be payroll deducted)
Your plus number:	*	Example: +12345678
Home telephone number:	*
Mac address of your cablemodem:	*
Permanent home address:	*	Street: City: State: Zip:
Desired installation date (please allow 5-7 business days):		(mm/dd/yyyy format) Note: We must contact you to schedule an appointment. Installation appointments are on a first come, first serve basis, and you must be present for service to be activated. This is necessary even if you choose the Self Installation option below.

Service: (Note: New rates effective July 2009)
		New Road Runner High Speed Data $24.00 monthly for students, $34.00 monthly for faculty/staff There is also a $25.00 service charge.

Installation Requirements:
Be sure your system meets the minimum requirements for installation
	Yes No	Do you already have a working Cable TV service in your residence?
	Yes No	If no working Cable TV service, is there a Cable TV outlet in your residence? Note: Your PC for Internet access must be within 10 feet of a cable TV outlet.
	Yes No	If no Cable TV outlet, would you like Time Warner to provide an estimate of the cost to install an outlet? Note: Time Warner Cable will quote the cost of installing your outlet; written landlord permission is required for installation.

Before you click "Submit": Read This - It's about your money:

You must cancel or transfer your service when you leave the address. Otherwise you will be paying for a service you're not using.
You can only cancel your service by completing the Road Runner Disconnect Request form on-line.
You will be billed for any extra charges that may appear on the account.
You agree to make your payments in accordance with the Bursar's standard policies.
You agree to all the Terms and Conditions of use. For Road Runner Terms and Conditions, check the Usage Policy choice on their webpage at http://www.roadrunnerohio.com/usepolicy.html
Please understand that failure to pay will result in your service being cut off (subject to a reconnection fee) and being subject to normal University policy regarding non-payment of obligations.
You agree that submitting this form authorizes NSE to release the above information to Time Warner cable for the purpose of their service installation.
Miami University receives compensation when providing this service. Please consider your needs and financial capabilities carefully when you are determining whether to purchase this service.

I have read all of the above information and agree.

These services are offered by Miami University Network Services Enterprise in cooperation with Time Warner.

Support Information:

Service Address: This must be an EXACT street address, within Time Warner Cable's Oxford service area.

Plus Number: This number is issued by Miami University for record keeping. You can find your Miami University Plus number on the "Telephone Charges" statements we send, or on your Bursar statement.

Minimum Requirements:

Windows PC: Penitum 75Mhz, 32 Mb RAM, 150 Mb free hard drive space and CD-ROM drive. Windows 95/98 or NT 4.0 Workstation; Windows 2000 or Windows ME.

Macintosh: Power PC 75Mhz, 32 Mb RAM, 50 Mb free hard drive space and CD-ROM drive. System 7.6 (excluding MacOS 8.5) installed on a non-networked computer, and Open Transport v.1.1.1

Finding your MAC address: Each cable modem has a unique network MAC address for identifying itself to the network. See our page on Road Runner Information for more details about the cablemodem's MAC ID.

Terms and Conditions: For Road Runner Terms and Conditions, check the Usage Policy choice on their webpage at http://www.roadrunnerohio.com/usepolicy.html.

For additional information, or assistance in completing this request, please call us at (513) 529-8774 or send e-mail to NSE@muohio.edu.