Maintenance Request Form
Leveller's Co-op Digital Request Form

Please note, this form is not for emergencies. Please call the Emergency Contact if you are experiencing an emergency.

If you have problems using this form, please email maintenancechair.levellers@gmail.com
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Date of Request *
MM
/
DD
/
YYYY
Member Name *
Unit Number *
Urgency of Issue *
High
Low
Description of Issue *
Specific Area that Requires Work *
Please select one of the following: *
THIS FORM IS NOT FOR EMERGENCIES
In case of an emergency, please phone the Leveller's Emergency Contact

Examples of an emergency:
- Member is locked out
- Flooding that is currently happening

If the Leveller's Emergency Contact does not answer after several attempts, call Hans

If there is a fire, CALL 911
If there is an active break in, CALL 911

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