TMA iServiceDesk - Work Request Form

Task Chair Request Form
-INSTRUCTION-
**All fields in RED must be filled out
1. Select a LOCATION where work is to be performed or delivered to ==> Campus/Facility, Building, and Area
2. Fill out REQUESTOR INFORMATION ==> Full Name, Phone #, TCC Email, and Department
3. JUSTIFICATION will default to ==> repair/replace
4. Provide photos of existing chair to be replaced and the manufacturer's tag under the seat (Please create a Word Document to include both photos)
5. Select a new/replacement chair from the chair selection table below and fill in the Employee Name and Office location where the chair is to be delivered.

IMPORTANT NOTICE!
One Request Per Individual

Campus/Facility:

Building:

Area:

Full Name:

Phone #:

E-mail Address:

Repair Center:

Department:

Request Action:
(enter description,
justification,
date and time
area available)

Task Chair Justification

File Attachment:
(Allow one attachment only)

CHAIR SELECTION Select only ONE chair, enter employee name and office location. NOTE: Provide photos of existing chair to be replaced and the manufacturer's tag under the seat (Please create a Word Document to include both photos and upload to the File Attachment below)
Task Chair Image	Task Chair Selection	Chair Type	Employee E-mail	Office Location
		Mesh Back
		Fabric Back
		Big & Tall