Maintenance
Request Form

Student Name *

First Name

Last Name

Phone

(###)

###

####

Date of Request *

MM

DD

YYYY

Preferred Contact Method *

Email

Phone

Type of Issue *

Plumbing (e.g., leaking faucet, clogged drain)

Electrical (e.g., power outage, faulty switch)

Heating/Cooling (e.g., broken thermostat, HVAC issue)

Appliance (e.g., malfunctioning refrigerator, broken stove)

General Repairs (e.g., door handle, window)

Pest Control

Other (Please Specify Below)

Severity of the Issue *

Emergency (e.g., flooding, electrical hazard)

Urgent (Needs to be addressed within 24-48 hours)

Non-Urgent (Can wait a few days)

Preferred Time for Maintenance Visit *

Morning (9AM - 12PM)

Afternoon (12PM - 4PM)

Evening (4PM - 7PM)

No Preference

Permission to Enter *

Give permission for the maintenance team to enter my apartment if I am not present.

I prefer to be present during the maintenance visit.

Acknowledgement *

I understand that by submitting this form, I am requesting maintenance or repair services for my apartment. I also acknowledge that any damage caused by negligence or misuse may result in additional charges.

I agree to the terms above