Subscriber Contacts Update Form To update your contact information (e.g. authorize individuals at your organization to modify your OneNet services), please complete and submit the form below: Subscriber Contacts Update Form Completed by* First Last Title*Email* Name of Organization/Agency/Institution/School*Account Number (listed on your invoice)*How many OneNet account numbers do you have?* One Multiple, but contacts below apply to all accounts Multiple, with some account-exclusive contacts not listed below (Please submit another form for other accounts) Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone (Main/Front Desk/Central Switchboard)*After-Hours Phone*Administrative Contact*The Administrative Contact has authority to request modifications to your OneNet circuit or services. He/She is the primary contact for contract administration and is the only person who may modify a contract. First Last Title*Phone*ExtensionFax*Email* Billing Contact*The Billing Contact has authority to modify your billing address and frequency and is OneNet's contact for resolving billing discrepancies. First Last Title*Phone*ExtensionFax*Email* Email Address to Receive Invoices*Please provide an email address to receive invoices from OCAN/OneNet. This email address can be the same as the billing contact or different but only a single email address can be used to receive invoices. On-Site Technical Contact*The On-Site Technical Contact is available full-time at the circuit site and coordinates with OneNet for basic connectivity needs and troubleshooting. Extensive technical knowledge is helpful but not required. This contact also has authority to request technical changes to OneNet services. First Last Title*Office Phone*ExtensionMobile PhoneFax*Email* Access HoursTechnical ConsultantThe Technical Consultant Contact has authority to request technical changes to OneNet services such as web and email hosting. He/She may be a contracted or off-site technician. First Last TitleOffice PhoneExtensionMobile PhoneFaxEmail Access HoursE-Rate ContactK-12 Schools & Libraries Only: The E-Rate Contact is responsible for resolving questions related to E-Rate applications and funding awards. First Last TitlePhoneExtensionFaxEmail Website ContactThe Website Contact has authority to modify and update your website and web services, including modification of website-related domain names. First Last TitlePhoneExtensionFaxEmail Email ContactThe Email Contact has authority to modify and update your email services, including modification of email-related domain names. First Last TitlePhonePhoneExtensionEmail Abuse ContactThe Abuse Contact is your liaison in the event of abuse of OneNet circuits (e.g. illegal file sharing, spamming). IP addresses assigned by OneNet will list this person as primary contact. First Last TitlePhoneExtensionFaxEmail PhoneThis field is for validation purposes and should be left unchanged. Δ