Cornell University Institutional Service Request

Service Request Form

This form is for requesting account service, assistance with equipment installation or operation, or to terminate your existing institutional service subscription.

Contact and Account Billing Information

* University Department:
* Primary Contact Name:
* Contact University Telephone #:
* Contact University Other Phone:
* Contact University Email
* Confirm University Email
* Contact University Mailing Address:

* City
* State:
* Zip:
* Account will be paid by:	Check Debit/Credit Card
Department Network Administrator Contact Information:
* Name:
* Phone:
* Email:

Service Locations

Loc. No.	Building Name	Room Number	Receiver ID# (RID#)

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10.


(If you have more than 10 locations, please fill out a second form)

* Please describe your request:

Once you submit this request, we will contact the primary contact listed above. If this is a termination request we will schedule an appointment to retrieve the institutional receiver equipment.

Please call (866) 615-8674-Option 1 to speak with a customer service representative. Normal business hours are 9:00am - 5:00pm Eastern. Emergency calls are accepted anytime.