Wufoo
Maintenance Request Form
*Any repair requiring funding must be approved by the principal.
If a response is not received after a week, please email Mr. Brand (jgb7324@lausd.net.)
From
*
First
Last
Email
*
Room Number
*
Request Type
*
Emergency (Immediate Danger to Health or Safety)
Urgent (Danger To Health or Safety but not immediate)
Routine (Everything Else)
Check All That Apply
*
Broken/Dripping Faucet
Sink stoppage
Heating/Air Conditioning Problems
Lights Burned Out
Door Locks
Door Rubs
Electrical Outlets Problems
Ceiling Tiles Loose
Broken Blinds
Pest Control/Ants – Bugs
Broken/Missing Floor Tile
Broken Glass/Window
Broken Soap/Towel Dispenser
Other
Do Not Fill This Out
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