Sports Broadcasting Order Form

To order Sports Broadcasting Connections please complete the form below and click the submit button once. By submitting this form, you have agreed to the terms and pricing for Sports Broadcasting services. All email addresses are required to successfully submit the order. Your information will be sent to ist_sports@lists.berkeley.edu. IST will manage all assigned lines and subsequent billing.

Broadcasting Company: *

Name of Broadcasting Company

Contact Name: *

Contact Name

Email : *

email address

Daytime Telephone: *

telephone number

Billing Contact Name: *

Name of Billing Contact

Billing Address: *

Street Address

City: *

City

State: *

State

Zip Code: *

Number of Lines: *

Number of lines requested. Pease note that if you will be ordering multiple lines with the same or different activation and disconnect dates, add it to the comments section of this order.

Multiple Line Comments:

Please use this box to add information about additional lines.

Type: * Standard Line1MBISDNOther

Please select the type of line.

Line Activation Date: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050

Activation date

Line Disconnection Date: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050

Disconnection Date

Location: * HAASStadiumOther

Event Location

Other Location:

If you selected other, please specify the location.

Additional Comments:

Additional Comments