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College of Science Equipment Repair Request  
Electronic Request For Assistance & Service
  • Fill in the form as completely as possible.
  • Incomplete Information will result in service delays.
  • All requests for assistance should be in writing or on this form.
  • Limit your phone calls...ALL REQUESTS or QUESTIONS must give complete 
    information and be logged into the work order tracking system.
Name/Contact (E-mail address):
Department:
Phone  Extension:
Building Room #:
What Type  of Equipment Are You Using? 
Are Technical Manuals Available?
CC Number (Property of Columbus State University Tag - Located on side of equipment):
Department Account #:  
Model Number:                                 
Serial Number:  
What are you having problems with?


Has equipment had preventive maintenance?
What is your question/request?

 
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