Maintenance Request Form

Employee Information

First Name *

Last Name *

Email Address *

Phone Ext. *

Work Request Details

Please provide the appropriate responses to the following items relevant to the location where the work is to be done by the Maintenance Department.

Date Needed *

Month

Day

Year

Campus *

Building-Location *

Other Location *

Please describe the location where the work is to be done in the space provided above.

Room No. *

Moving?

Yes

By checking Yes above, a ticket will automatically be created for Computing Services so they can provide assistance with moving computers and phones to the new location and updating the appropriate records as to your new location.

Describe Work Needed *

Image Upload

If needed, you may upload an image in support of your request. Simply use the Choose File button to browse to the location of your photo and click the Upload button. A maximum upload size of 2 MB has been set and only the following types of files will be accepted: GIF, JPG, PNG,PDF, DOC and DOCX.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

Are you changing or canceling a maintenance request previously submitted? *

Special Instructions/Comments

Please provide specific details in the Special Instructions/Comments field.

Form Submission

Automatic Routing: Behind the scenes and based on the information provided on your form, the following individuals will immediately receive an email with the details of your submission:
1. You
2. Vice President and Chief Business Officer
3. Key maintenance staff
4. Your supervisor (based on email address entered in Supervisor Email field below)
  Note: Your immediate supervisor must approve all Maintenance Requests. Please insert his/her email address in the field provided below.
5. Additional Recipients, if any, (based on email address(es) entered in Additional Recipient(s) field below)
  Note: If you need to include more than one email address in this field, simply insert each additional email address in the field separated by a comma (and no spaces), for example: rschmeichel@swmich.edu,jluthjohan@swmich.edu.
6. If you checked Moving above, a ticket will automatically be created in the Computing Services Ticket system when this form is submitted.
7. A ticket will be automatically created in the Maintenance Ticket System when this form is submitted.
Submitting the Form: Once you have filled in all the required fields (which are designated with a red asterisk), click on the Submit Maintenance Request Form button to electronically transmit your form and activate delivery of the automatic routing detailed above.

Supervisor Email *

Additional Recipient(s)

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Maintenance Request Form