Computer Help Request Page

Equipment Work Request Form

Name:
Phone:		E-Mail:
Branch:		Date Requested:

Enter your requested work in the space provided below. Please enter computer Number, (500-012) or device type,( printer, scanner, etc...) . If reporting a problem with a device, give a description of what applications you were using when the problem happened.
Requested Work
*Note: Request are completed in order of importance.*

List Requests

PCC Workforce Network is an Equal Opportunity Employer/ Program Auxiliary aids and services are available upon
request to individuals with disabilities. To place a free relays call in Oregon dial 711. This program financed in whole or in
part with funds provided through Worksystems, Inc. from the U.S. Department of Labor. 4/12/07