ES/TSMS Printer Ink Cartridge Replacement Form
Does your printer need a new ink cartridge? Just fill out this handy form and submit it to me.

Please be advised that the school may not be in a position to replace all printer cartridges so exercise discretion when printing.

[form updated 3/7/16]
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Before requesting a replacement, did you already remove your cartridge, shake it up, put it back in your printer and keep printing for a while? *
Shaking up your cartridge usually gives you many more weeks, sometimes months of ok printouts. :-)
My name: *
I am at: *
Office, Classroom, or Laptop Cart NUMBER: *
Ex: Room 138,  H-Cart
My e-mail address: *
My printer is a: *
(The Model Number on the outside of the printer, not the cartridge part number on the cartridge)
Which color ink color cartridge(s) need replacement? *
Check all that apply:
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