Maintenance Request Form

Please fill out this form to report maintenance issues in your dorm room. Note that issues with lamps, furniture removal, computing and laundry machines do not go through the Maintenance Request process. In addition, resident student Maintenance Requests are limited to residence hall rooms and should not be submitted for common areas. Contact your RA or a Residence Life professional for assistance for these issues.

Be specific with the issue. Give the exact location, potential cause and duration of the problem. Be sure to alert your RA or a Residence Life professional if contact is not made or if the request is not addressed within 24 hours.

Residence: *

North

South

House 95

House 103

Apartment or Room #: *

Full Name: *

Please enter your first and last names.

Email Address: *

Be sure that your email is correct and complete.

Phone Number: *

Phone number, formatted as (716) 123-4567, at which you can be reached for questions

Resident Assistant: *

Please select your RA's name. A copy of your email will be sent to them.

May Facilities staff members enter your room while you are out?: *

Yes

Please note that the facilities staff will never enter your room individually; they work in pairs.
If not, please offer several options for your availability below - include days, times and dates

Availability for service:

Please be specific. Provide dates (MM/DD/YY) and times (7:00 a.m. to 9:00 p.m.), for example.

Description of issue: *

Please be very specific to ensure prompt attention.

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