Work Order Request Form

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Work Order Request Form
Please complete all sections of the form and file in the Work Order Log in the Hall Office.
Date Reported: _____/_____/_________
RA Name: ___________________________________________
Location
Floor/wing: __________________________
Area (bathroom, room, etc): _______________________
Room #: ______________________________
Side of the room:
Left
Right
Problem Type (circle the most accurate selection):
Electrical Door
Carpentry
Construction
Electrical
Access
Heating/Ventilation
Electronics
General Maintenance
Grounds
Air Conditioning
Housekeeping
Key/Lock
Miscellaneous
Painting
Plumbing
Roof
Vehicle Maintenance
Furniture
Detailed description of the problem or request: ______________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Time available for maintenance: ___________________________
Requested Completion Date: _____/_____/________
Was this an act of vandalism?
Yes
No
If yes, responsible student(s) include M#s: _______________________________________________
_________________________________________________________________________________________________
Graduate Assistant Use Only
Date Submitted to SchoolDude: _____/_____/________
Work Order ID: ____________________
Yes
No
Follow up action required to have request completed:
If yes, what action did you take? ____________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Work Order Completion Date: _____/_____/________
Notes: _______________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

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