RESIDENCE LIFE
2039 Kennedy Boulevard . Jersey City . New Jersey . 07305        Phone: 201-200-2338
Maintenance Work Request Form
 
Complete this form to submit a request for maintenance work.
 
NOTE:  If your request involves the heating system in your room or residence hall,
please consult Residence Hall Staff first.

Sections/Fields marked with an asterisk (*) are required in order to process your request.

*General Information
 
*Detailed Reponses
Your Full Name
Your Room Extension
Building (name of residence hall or house)
Room number
Resident Assistant (RA) Cell Phone Number
*Resident Counselor (RC) Email Address
A copy of this form will be sent to the email address you provide here.
(ie. username@njcu.edu)
Work Request Types



  
Description of problem (be as specific as possible):
*Your Full Email Address
A copy of this form will be sent to the email address you provide here.
(i.e. username@njcu.edu)

If you encounter any difficulties, please contact the ITS Web Developer at helpdesk@njcu.edu
. Thank you.