Technology-Related Problem Report
This form is to be used when requesting assistance with or repairs for instructional or administrative technology (computers, printers, Smartboards, projectors, etc).

You must complete each field in each section. This form will be automatically delivered to the Assistant Principal of Technology and put in a queue.

Maintenance or assistance will be scheduled according a needs assessment and subject to the availability of staff and equipment.

Do not submit multiple forms for the same problem. This will result in a longer wait time for assistance.

Please Use This Section To Provide Us With Your Contact Information
Last Name *
Your answer
First Name *
Your answer
Your Room Number *
Your answer
Your Email Address *
Your answer
Your Extension *
Your answer
Please Use This Section To Provide Us With A Description Of The Problem
Please Select The Period(s) You Are in The Room *
Required
Select the item that best describes the type of problem you are experiencing. *
For multiple problems, please select all that apply.
Required
Briefly describe the nature of your problem in clear and concise language. *
Your responses will be limited to 350 characters.
Your answer
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This form was created inside of Fort Hamilton High School.