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Request/Repair Form (2007~2008)

Please note, you must complete all areas of this form.
If you need to 'fill' in a blank space use the example in the parentheses.
We will set priority based on information provided and YOUR submitted priority.
You can have only ONE REPAIR REQUEST per form.

If the form is INCOMPLETE, please read the error message for assistance.


Name
(remember you must complete all areas)
(you must place your name here)
Priority
(remember you must complete all areas)
(you must make a selection from the menu)
Building
(remember you must complete all areas)
(you must make a selection from the menu)
Type of Request
(remember you must complete all areas)
(you must make a selection from the menu)
Location/Room Number
(remember you must complete all areas)
(this is required, use the room number where
the equipment is located or use 9999)
Email Address
(remember you must complete all areas)
(use your school address or use
shelby_9999@shelbyk12.org)
Shelby Tag Number
(remember you must complete all areas)
(four number minimum, if you have
NO tag number use 9999)
Serial No.
(remember you must complete all areas)
(this field is required, use 9999 if you have no serial number)
Equip. Manufacturer
(remember you must complete all areas)
(you must make a selection from the menu)

Hard Drive Name
(remember you must complete all areas)
(use the example below or type in: SCS_999_9)

Type of Equipment
(remember you must complete all areas)
(you must make a selection from the menu)
Hard Drive Name only applies to MAC computers
Example: SMS_303_2

PLEASE CHECK AND MAKE SURE YOU COMPLETED ALL SECTIONS ABOVE!!

The section below IS REQUIRED. Describe the problem to the best of your ability.
If possible, type in any error message you received that could assist us in solving the problem.



Updated: November 6, 2007
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