Technology Service Request Form

Please fill out the following form and click submit. (Just once please)
PLEASE SELECT THE APPROPRIATE SCHOOL SO THAT THE REQUEST WILL BE ROUTED PROPERLY.

Please Choose LAKEVIEW WCHS WJHS WES MES MMS MHS HCVC ALTERNATIVE CENTRAL OFFICE SCHOOL (Use the drop down box to select your school)

USER

EMAIL ADDRESS

ROOM NUMBER

COMPUTER NAME

DATE

ARE YOU SUBMITTING FROM THE PC THAT NEEDS SERVICE?
Please Choose Yes No Does Not Apply
(Since this form provides network information about the PC that you submit from, submitting from the PC that needs service will greatly assist us in starting the initial diagnostics . If you can not submit from the PC for any reason, please submit from the next closest unit)

Briefly describe the problem.