Maintenance – Request Form Maintenance Request Step 1 of 2 50% Contact Information Point of Contact(Required) The Point of Contact should be regularly available during business hours and on-site to answer any follow-up questions from the building coordinator or UW Facilities employees. I will be the contact Someone else will be the contact Your Name(Required) First Last Your Email(Required) Contact Name(Required) Name of individual who will serve as contact. First Last Contact Email(Required) Email of individual who will serve as contact. Contact Phone(Required) Phone number of individual who will serve as contact. Contact Location Office or room number of individual who will serve as contact. Action Request Building(Required) Gerberding HallSchmitz Hall Floor Number(Required) Provide the floor number of the location where service is needed. Room Number or Location(Required) Provide the room number or describe the location where service is needed Maintenance Type(Required) plumbing | clog elevator(s) lighting window(s) lock(s) | door(s) graffiti | vandalism power | internet outage bio cleanup | custodial service Other Maintenance or Service(Required) Describe the maintenance or services required.