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Tech Maintenance Work Request Form



Please fill out the top section of this form and give it to the appropriate person listed below: ===================================================================================================================

Equipment Malfunction (DVD, VCR, LCD Projector, Digital Camera, Document Reader, etc)....................................Mr. Berndt, Media Specialist
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Hardware /Software Problems (within the classroom)................................................................................................Mr. Lawson
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Network Problems, Printer Problems (outside of the classroom)...............................................................................Mr. Berndt, Media Specialist
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Computer Lab Problems..........................................................................................................................................-Mr. Berndt, Media Specialist
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Video Distribution System........................................................................................................................................-Mr. Berndt, Media Specialist
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Circle the appropriate area: Classroom Computer, Classroom Printer, Computer Lab, Video Distribution System, Network, TV, VCR, DVD,
Digiital Camera, LCD Projector, Document Readers. Name: Room: Date Submitted: Problem (in detail please): ============================================================== This section to be completed and signed by person responsible for this area: Actions taken and results of Actions: Maintenance Completed by: Date Completed: Specific Time: Total Minutes Spent:

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Please feel free to contact us with comments and suggestions at eberndt@nfsd.org