Microsoft Forms

Vending Machine Refunds and Maintenance Request

The Office of Business & Auxiliary Services
The reason for this submission? *

I am reporting a maintenance issueI am requesting a refundI am providing feedback/suggestions

Method of payment used?*

CashDeclining balance dollarsCredit card, Apple or Google PayRamCard

Credit Card, Apple, & Google Pay Notice

If the item selected was not properly dispensed, credit card refunds are automatically returned to the original card within 3-7 business days. Please check with your bank to confirm the pending charge was removed before submitting a refund request.
Please select the following*

Received expired/faulty productProduct never dispensed

Refund/Maintenance Information
Transaction Amount: *
Problem Description*
Refund/Maintenance/Feedback description
What type of machine was used?*

BeverageSnack

Select the location of the Beverage machine:
Today's date

MonthDayYear
Date

Select the location of the snack machine
Today's date

MonthDayYear

Contact Information
First and Last Name : *
Banner ID (If applicable)
University Email:*
Phone Number: *
Should be Empty: