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Phone Service Disconnect Request

This form is for requesting deactivation of local phone service or optional features. Fill out the form completely and then submit it. Please allow 24 business hours for deactivation.

First Name:

Last name:

WIN #:

Email:

Residence Hall/Apartment Building:

Residence Hall/Apartment/Room Number:

Date to disconnect services: (MM/DD/YYYY)

Note: you will be billed for services until the date that this form is received or the future disconnect date you have specified.

Need More Help?

Telephone service representatives may be reached at (269) 387-4357, Option 2, or send email to .