Maintenance Staff Request
Sign in to Google to save your progress. Learn more
Email *
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
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lewis Central Community School District. Report Abuse