Louisiana State University Eunice Service Request Form
Office of Information Technology
Date: _____________________ Department Name: _________________________ Work Order No. _________
(To be filled in by OIT)
Contact Person: ___________________________ Extension: __________________
Typ
e of Request: PC Hardware ____ PC Software _____ CX Report _____ CX Job _____
Det
ailed Description of request: (If you are requesting a new report please attach a sample of the proposed output.)
All Work Requests must be received at least 72 hours prior to the requested date of completion.
Requested Date of Completion: ______________________ (A valid date must be entered -- ASAP is not acceptable)
St
ate reason below for work:
Signature or Requester: _________________________________________________ Date: _______________________
Si
gnature of Supervisor: _________________________________________________ Date: _______________________
This Section for OIT Use Only
Received By: _________________________________________________________ Date: _______________________
Assigned To: _________________________________________________________ Date: _______________________
Completed: _________________________________________________________ Date: _______________________
Reviewed By: _________________________________________________________ Date: _______________________
Special Notes:
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