Maintenance Staff Request
Email address *
First and Last Name *
Type of request *
Location of requested cleaning, maintenance/repair or safety concern. *
ex. Room 1111 next to the door
Description of request. *
ex. There is a stain next to the door and loose carpet in the same area.
Would you like for someone to follow up with you about your request?
Clear selection
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Lewis Central Community School District. Report Abuse