COMPUTER REPAIR REQUISITION
Upon completion of this form please forward to your main office.
DATE: ________________________ SCHOOL:_______________________
CONTACT: ________________________ ROOM NUMBER: _____________________
COMPUTER MODEL: _______________ PRINTER MODEL: ____________________
COMPUTER NUMBER OR NAME _____________________________________
***PLEASE IDENTIFY COMPUTER NEEDING REPAIR IF NOT LABELED OR NUMBERED*****
(place a sign on computer if unidentifiable)
PROBLEM(S):
__________________________________________________________
REPAIR DATE: _____________
REPAIR(S):
___________________________________________________________