Facilities & Maintenance Request Form
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Room/Office Number
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Alternate Contact
First Name
Last Name
Phone Number
Please enter a valid phone number.
Building/Location
*
Please Select
Admissions
Baseball Field
Battle Hall
Bedford Hall
Blacktop
Blanton Hall
Booker T. Washington
College Bookstore
Dining Hall
Early Headstart
Golson Humanities Building
Guerry-Finlay Hall
Halmi Hall
Leonard E. Dawson Center
Living Learning Center
Massachusetts Hall
Menafee Hall
Physical Plant
President's Residence
RBC Rural Health Center
Saint James Building
Security Gate House
Softball Field
St. Phillips Chapel
Track
Voorhees Science Center
Wilkinson Building
Wright Hall
Wright-Potts Library
Location of Problem or Need
*
Problem Type
*
Please Select
Appliance Repair
Carpentry
Ceiling
Contractor
Custodial
Delivery
Doors and/or Hardware
Electrical
Elevators
Environmental Services
Event Break Down
Event Setup
Fire Protection
Glass/Window Repairs
Grounds
Heating/Ventilation Air Conditioning (HVAC)
Keys and/or Locks
Leaks
Lighting (Indoor)
Lighting (Outdoor)
Moving
Painting
Pest Control
Plumbing
Pool
Roof
Water Fountains
Other
Description of Problem or Need
*
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of
For Office Use Only
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Month
-
Day
Year
Maintenance Appointment Date
For Office Use Only
Maintenance Request Completed By
For Office Use Only
-
Month
-
Day
Year
Date
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