Work Order Request Form

1.   Date:

2.   Your Name:  

3.   School:   Select One AHS DMS WMS WHM BAN HPE SAN SHA SOU WEL CO         Is this a Special Education request?    Select One No Yes

4.   Room #:  

5.   Telephone number:   

6.   Inventory Control Number (ICN):  

(The ICN is the inventory number assigned by the Technology Department to each piece of equipment.  The ICN tag is a gold, blue, or red metal tag with a number printed on it.  We also write ICN directly on each piece of equipment, usual just above the ICN tag. )

7.   Type of equipment:    Select One Computer Email Internet Laptop Monitor Network PDA Printer Software Camera Projector Scanner TV VCR DVD AlphaSmart OTHER

8.   Explain problem (Please be as detailed as possible with your description of the problem):