NJC Maintenance Request Form
Please complete the form below:
Date
*
Title
*
Select
Mr.
Miss
Mrs.
Ms.
Dr.
First Name
*
Last Name
*
Cell Number
*
Email Address
*
Campus Location:
*
Select One
North
South
MidTown
Area in Need:
*
Select One
Computer Room
Conference Room
Fellowship Hall
Gym
Kitchen
Nursery
Sanctuary
Classroom
Corridor
Office
Academy
Men Toilet
Women Toilet
Storage
Lobby
Other
Please list area for maintenance or repair: (Be sure to give complete description of problem, location, and possible solution.)
*