Resident Room Repair Request

1

Work Request Status:

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2

Tell us your name!* This field is required.

First Name

Last Name

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3

What is your YC scholar email address?* This field is required.

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4

What is your Y#?* This field is required.(It's conveniently located on your student ID)

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5

Which Hall do you live in?* This field is required.

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6

What is your room #?* This field is required.

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7

So, there is a maintenance issue in your room?* This field is required.Please provide a detailed explanation of the issue. The more information you give us, the easier it will be to help you!

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8

Picture time!If possible, please upload us a picture of the issue so we can better inform the facilities crew of your needs! You can mark up the image in order to highlight the problem.

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9

What is your phone number?* This field is required.

Area Code

Phone Number

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10

Can Residence Life text you with updates on the progress of your repair request?* This field is required.

YESNO

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11

Can Residence Life text you with important updates regarding your housing?* This field is required.Ex: Deadlines, pending charges etc.

YESNO

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12

By submitting this Room Repair Request, I grant staff permission to enter my room to conduct the necessary repair. * This field is required.

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