Ticketing System Intake form

Description of services provided:

• Basic repair / Maintenance work - Repairs to physical space/room (lighting, HVAC, electrical, etc, please contact Rishav or facilities management)
• Moving of heavy items
• Building new furniture
• Hanging pictures or items on the wall
• Millwork repair (basic repairs like door hinges etc.)
• Other services will be considered based on the request
Name:
Department:
Room:
E-Mail:
Date Requested: Date Requested: / MM / DD YYYY

(5 business days notice requested where possible. We will consider last-minute work based on availability)
Completion Date Requested: Completion Date Requested: / MM / DD YYYY
Best time(s) to access space to complete Job: Best time(s) to access space to complete Job: : HH MM AM/PM
Describe work:
USC department account #

(Include for jobs that require materials/supplies to be purchased)