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Venice Skills Center
Technology Service Request Form
First Name *
Last Name *
LAUSD E-mail Address *
Phone Number
Campus *
Which campus are you located in?
Office/Room *
What office/room are you located in?
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
Low Priority
Are you the user? *
Is this an Administrative job request? *
When did you first notice this technical issue? *
MM
/
DD
/
YYYY
Which device(s) has a technical issue(s)? *
Required
Please describe the technical issue(s) with the device(s) you selected above. *
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
:
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