Berry Employee Number:
Berry Telephone Number:
Last Name:
First Name:
Middle Name:
Home Address:
City:		State: Choose One. . . Georgia Foreign Country Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware Dist. of Col Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Code:
Berry Housing Unit Name:		Move-In Date:
City:		State: Choose One. . . Georgia Foreign Country Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware Dist. of Col Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Code:
Office Telephone Number:
Email:

Please Check Services Desired:

Basic Telephone $15.00

Caller ID $2.00

Misc. Charge p/m

Voicemail $5.00

Internet $20.00

Cable TV $20.00

Paging $7.95

Atlanta Line

Long Distance (Vonage)

Long Distance (Qwest) $0.09 a minute

By checking this box, I acknowledge that I have read and agree to the terms and conditions that apply.

Terms & Conditions of Contract

Berry College Office of Telecommunications (BCT) hereby contracts to provide the services selected to the above-named tenant in accordance with the following terms and conditions.

1.  CONTRACT DURATION: The duration of this contract will be from the signature date of this contract until cancellation notice is received from either the tenant to BCT or BCT to the tenant.

2.  GENERAL INFORMATION: Basic Telephone, Caller ID, Voicemail, Internet, Comcast Cable TV, Paging and Qwest long distance are available separately and will be activated upon receipt of a signed BCT contract. The Berry telephone system does not accept collect calls.

3.  MEMBER OBLIGATIONS & LIABILITIES:  The above named tenant is solely responsible for the calls charged to his/her account number and is the only person permitted to make inquires regarding the account.

4.  SERVICE & INQUIRIES: All service requests or inquiries must be sent to the BCT Office, P.O. Box 490519 Mount Berry, Georgia 30149-0519 or call (706)-238-7000.

5.  BILLING:  Each tenant possessing a BCT service will be billed monthly. Tenants hereby agree that all the charges will be payroll deducted from his/her Berry paycheck. Billing discrepancies must be brought to BCT’s attention before the next billing date. Adjustments will not be made after that date. BCT account statements will be distributed Berry College campus mail system, campus e-mail, or with paychecks as appropriate.

6. QWEST: Qwest is a more stable long distance carrier than Vonage resulting in significantly fewer dropped calls. In addition, a tenant must have Qwest in order to make international calls. International calls cannot go out over Vonage lines.

7. BELLSOUTH ROME TELEPHONE DIRECTORY: You will no longer be automatically listed in the local Rome Telephone Directory or Bellsouth Directory Assistance (411) listings. You must request in writing to BCT to add you to those listings.

8. CABLE TV: Basic cable TV service is activated by BTC. Service requests and any additional other services are provided by Comcast. You can contact Comcast at telephone number 706-291-4942.