Request edit access
Venice Skills Center
Technology Service Request Form
* Required
First Name
*
Your answer
Last Name
*
Your answer
LAUSD E-mail Address
*
Your answer
Phone Number
Your answer
Campus
*
Which campus are you located in?
Venice Skills Center (Main Campus)
Emerson Campus
Hamilton High – Adult School Office
University Campus
Venice High School Campus
Home
Other:
Office/Room
*
What office/room are you located in?
Your answer
Please Rate the Level of Urgency
*
Please note that we will be handling issues as soon as possible, times are only estimates and may not directly reflect how quickly we can respond to requests.
URGENT
1
2
3
4
5
Low Priority
Are you the user?
*
Yes
No
Is this an Administrative job request?
*
Yes
No
When did you first notice this technical issue?
*
MM
/
DD
/
YYYY
Which device(s) has a technical issue(s)?
*
Desktop/Laptop Computers
Printer/Ink
iPads/Chrome Books
Projectors/Document Viewer
Internet Services
Other:
Required
Please describe the technical issue(s) with the device(s) you selected above.
*
Your answer
What is the due date for this service request?
*
MM
/
DD
/
YYYY
What is the best time for me to come by your office/classroom/remote session to resolve this technical issue?
*
Time
:
AM
PM
Submit
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of LAUSD.
Report Abuse
Forms
