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Network Services Enterprise (NSE) — Change of Service Form

Off-Campus Telephone and Road Runner

Please note: This form advises us whether to keep or disconnect your services. To avoid unwanted service disruptions, or unnecessary charges, all telephone and RoadRunner users must submit this form.

Please provide the following information: (an * denotes required fields)

Personal Information:
First name:	*
Last name:	*
Provide a telephone number where we can contact you or leave a message:	*	Please include area code.
Your e-mail address where you can be contacted:	*
Your plus number:	*	Example: +12345678

Type of Service and Owner Information:
	Telephone:	I am the lineholder	I am a roommate		Telephone Number:
	Road Runner:	I am the modemholder	I am a roommate with a secondary IP	I do not have Road Runner service	Cable modem Mac ID:
Please enter the current address where this phone or cable modem is in service:
Room or apartment number:
Note: If you want to change service on more than one line, or services at two different addresses, fill out a separate form for each line or address.

Service Changes: (Check ALL that apply)
	Service:	Telephone	Road Runner
	Keep in Service:
	Disconnect permanently:
	Date of disconnect: (mm/dd/yyyy format)
		Note: If the lineholder or modemholder disconnects their service, all roommates and additional IP accounts will be disconnected.
	Suspend over the summer:
	Date of disconnect: (mm/dd/yyyy format)
	Date of reconnect: (mm/dd/yyyy format)
		Note: For keeping service you will need a new authorization code for the summer and another for next fall.
	Reconnect at same address?	Yes	If no, provide the exact new address for service(s):
			Room or apartment number:
		Note: We will need to contact you to schedule an appointment to reconnect if you change your address(es).

Name Transfers:
	Service:	Telephone	Road Runner
	Transferring:
	New lineholder's/ modemholder's name for telephone/Road Runner service:
	Effective date(s): (mm/dd/yyyy format)

Address Transfers:
	Service:	Telephone	Road Runner
	Transferring:
	New Address:
	Room or apartment #:
	Effective date(s): (mm/dd/yyyy format)

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

Support Information:

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.

Contact Telephone Number: This must be a telephone number and e-mail address at which we can contact you over the summer, in case we have a question about reconnecting your services.

Modem Mac ID: This is a twelve-digit number on your cable modem, used to identify your cable modem on the network. It contains the numbers 0-9 and the letters A,B,C,D,E, and F. When entering your Mac ID, use only those capital letters. See our page on Road Runner Information for more details about the cable modem's Mac ID.

Terms and Conditions: See our Terms and Conditions page for telephone service terms and conditions. For Road Runner terms and conditions, select the Usage Policy option on the Road Runner web site 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.