LAB SUPPORT - REQUEST FORM
Submit Issue to NKLabSupport
** Mandatory fields are highlighted and preceded by an asterisk
*Title:
Priority:
Urgent
High
Medium
Low
Issue Information
Department:
Chemistry
Engineering
Science
Type of Request (Hold CTRL to select multiples):
Lab Equipment Demonstration
Lab Equipment Setup
Lab Equipment Troubleshooting/Repair
Lab Materials Preparation
Lab Teardown/Cleanup
Purchase Equipment/Supplies
Research/Evaluate
Other
If Type of Request was other, please specify:
Start Date (MM/DD/YYYY):
Start Time (Example 10:00 AM):
End Date (MM/DD/YYYY):
End Time (Example: 11:00 AM):
Building:
No Choice
Administration
Art
Athletic Center
Athletic Field
Blissell Library and Computer Center
Conference Center
Engineering
Offsite
Pavilion
Science
Student Union
Technology
Theater & IST
Room Number:
Course(s):
Section(s):
Reoccurrence Pattern (Example: M-W-F):
Contact Information
*Last Name:
*First Name:
*Email Address:
*User ID:
Description
Click the SUBMIT button to send your Request. You will receive an email confirmation if your Request is successfully registered. There is no need to reply to this email.
Be sure to click the submit button only once. A separate Issue will be entered each time the button is clicked.
Suggestions or problems with this form? Please e-mail Jim Rounce
jwr108@psu.edu
.