UM Housing Services - Northwood I, II, IV, V Cable Service Change Request


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housing services: Northwood I, II, IV, V Cable Service Change Request

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Northwood I, II, IV & V-Family Apartments & Northwood I & II Single Graduate Student Apartments Cable Service Change Request
Please fill out the information on this form and select the appropriate change to your cable service: Cancellation or Re-Activation.

Community*
Street Number*
Street Name*
Apartment Number
Apartment Phone Number (123-4567 )
E-mail address*	(from only 1 resident)

* denotes a required field

Service Change Requested (choose one)*

Cable Cancellation

Cable service is billed one month in advance and is prorated by the half-month only. Any credit due will be applied to your University Student Account within 6 weeks.

Re-Activation of Cable

If you have previously cancelled your cable service and now wish to have it reactivated. There is a one-time $12.50 reconnect fee in addition to the monthly service fee. Re-activation usually takes 7-10 days.

Requested action date:

As soon as poss bile

On a specific date

(Select your date below)

Resident Information*

Complete information is required in these fields.

Name of Leaseholder		UMID

* denotes a required field