Free maintenance request form 12
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Maintenance Request Form

North Campus

South Campus

Date of Request:


High Priorty


Room # or Classroom/Area:
Name of Requestor:

Phone #:

Description of Requested Work:

Signature of Building Principal

Custodian Assigned Task:
Date Work Completed:

Date for Task Completion:
Signature of Custodian:

This form should first be submitted to the building principal for approval and signature.
The form will
then be send to Jim Kribell, who will track the maintenance request in an Excel spreadsheet and will
assign the maintenance task to one of the custodians; and set the date for task completion. Each
building custodian will maintain a binder with maintenance and work orders, and then date and sign off
on the work order. A copy of the completed work order will be immediately sent back to Jim Kribell when