Maintenance Request Form

(Required information indicated in red.)

For issues with the form, please email housing@westga.edu.

REQUESTOR INFORMATION

Name:
Room Phone: (i.e. 9-9999)
Other Phone:
Email Address:

MAINTENANCE ISSUE DETAILS:

Building:
Building Letter: (i.e. A, B, or C)
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Wing:
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Wing:
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Building Number: (i.e. 1, 2, or 3)
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Building Number: (i.e. 1, 2, or 3)
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.

Building Letter:
Room Number: (i.e. 391B)
Location:

Issue:

Provide a DETAILED description of the issue, including exact location in the room, what exactly have been the issues, and what steps have been taken so far to troubleshoot the problem.