BSUConnect - Online Signup

Signup_AcadYr

Purchase BSU Caller ID, Campus Messenger, & BSU Prepaid Long Distance

Items with an * indicate a required field.

Student Information
Last Name *
First Name *
Middle Initial
Student ID Number *

Campus Address
Complex Name
Room Number
Campus Phone Number
E-mail address *

BSU Caller ID/Campus Messenger
Please Select Desired Service (choose all that apply)	Yes, I want both services - Academic Year (Aug - May) $50.00 Campus Messenger Only - Academic Year (Aug - May) $50.00 BSU Caller ID only - Academic Year (Aug - May) $50.00

Enhanced Voicemail
Would you like to add Enhanced Voicemail to your Campus Messenger service?	Yes No

BSU Prepaid Long Distance
$.08/minute within the US and Canada	Yes, I would like to signup for BSU Prepaid Long Distance
I want $____ of BSU Prepaid Long Distance Minutes. (please enter the dollar amount in the space provided)

Payment Information
Credit_Card *
Credit_Card_Number *
Expiration Date *
Name on Card (type as it appears on credit card statements) *

Billing Address
Address Line 1 *
Address Line 2 *
City *
State *
Zip *