Environmental Management Guest Room Maintenance and Housekeeping - Work Request Form

Date:

Time:

Residence Hall:

Room Number:

Guest’s Name:

Phone Number:
Room and/or Cell #

E-mail Address:

Maintenance:

	Electrical Issue
	Plumbing Issue
	Mechanical Issue
	Lock / Door Issue
	Shade / Blind Issue
	Window or Screen Issue
	Flooring Issues
	Painting or Plastering Issues
	Other:

Housekeeping:

	Extermination Issue
	Furniture Repair or Replacement
	Cleaning Issues
	Other:

Requested Service: