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Report a Problem

Please complete ALL fields so that we can provide prompt service.

1. Select appropriate media center for your classroom:

See the map of Office and Service Areas to find the correct location.

Media Center:

2. Requestor Information (about the person filling out this form):

Name:

Phone:

Email:

3. Instructor Information (about the equipment user):

Do not include password or universal identification number (UIN).

Instructor's Name:

Instructor's NetID:

Instructor's Phone:

Instructor's Email:

4. Course Information:

Course name, number, section:

Building Name:

Room Number:

5. Course Time Information:
Mon/Wed/Fri Classes
Tue/Thr Classes

6. Equipment Needing Repair:

If the item needing repair is not listed please select "Other" and use the Comments box below.
Equipment #1
Equipment #2
Equipment #3

7. Comments:

Please provide specific details about the problem.
Example comments: "The projector light bulb needs to be replaced."