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Maintenance Request Form
Type issue:
*
New maintenance request
Updated maintenace request
New modification request
Updated modification request
New computer related issue
Updated computer related issue
Other:
Priority
1 - Highest (Health hazard, severe damage to facilities, immediate attention)
2 - High (Risk of health concerns, may cause additional damage)
3 - Medium
4 - Low
5 - Lowest (mainly cosmetic or convenience need)
Submitted By:
First Name:
*
Last Name:
*
Campus
*
South High School
South Elementary
South Office
South Outside
North Elementary
North PreSchool
North Gym
North Outside
Other:
Room
Cell Phone Number (in case of questions):
(e.g. 893-552-9392)
Extension #
Date Submitted:
*
/
/
Month
Day
Year
Complete by date:
/
/
Month
Day
Year
Describe the need:
Clearly and completely describe the problem/issue.
*