Maintenance Work Order Form Work Order Date Requested(Required) Month Day Year Name(Required) First Last Requested By(Required) First Last Please enter the name of the person who authorized this request.Department(Required)Email(Required) What are you requesting? Please check all that apply.(Required) Transfer of furniture (cabinets, desks, appliances) Assemble New (cabinets, desks, appliances) Disposal of items (cabinets, desks, appliances, etc.) Install items (TVs, bathroom fixtures, lighting) Other Transfer To:(Required)Transfer From:(Required)Description(Required)Description(Required)Does the item still work?(Required) Yes No Storage?(Required) Yes No Can the item be taken off of inventory?(Required) Yes No Description(Required)Description(Required)CommentsNote: your office or building must be clear of old items before maintenance can complete a work order request. If office is not prepared or department is not prepared, then maintenance will not a perform work order request until office or department is properly ready.Requestor Signature(Required)
