Campus Facility Service Work Request


PLEASE NOTE:Once received by Facility Services, this form will be forwarded to the employee of the department who has the authorization, per the Controller's Office, to expend funds from this account. If he/she approves the request, he/she will e-mail Facility Services, stating either "okay" or "denied." Following the response via e-mail from the person who has authorization, proper action on the request will be taken.

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Requested By: Requested By Email Address:
Building: Phone: 
Room Number:  Index Code to be Charged: 



Department:  Department Head: 
Dept. Head's Phone:  Dept. Head's Email: 



Date Needed: 
Time Needed: 

Pickup Date: 
Pickup Time: 

Select One:

Non-Routine Request

Routine Maintenance Request

Description of Desired Work:

 

Special Instructions: