EmailMeForm
Maintenance Request
Please fill out this form and submit as indicated.
Submitted by:
*
First
Last
Email Contact
*
Date Submitted:
MM
/
DD
/
YYYY
Phone
###
-
###
-
####
Building :
*
Elementary School
Middle School
High School
Bus Barn
Classify Type of Work
Custodial
Maintenance
Grounds
Room/Location of Problem:
*
Describe what is needed:
*
Choose a Priority Level based on the affect on student learning environment.
*
HIghest (Done in 1-2 school days)
High(Done in 3-5 school days)
Medium (Done in 6-10 school days)
Low (2-3 weeks)
If this must be completed by a certain date due to an event, please input the date here:
MM
/
DD
/
YYYY
Additional information:
Custodial/Maintenance Staff sign and return to District Office when work is completed.
Clear
Date Completed:
MM
/
DD
/
YYYY
