Academic Technologies  - Barnard College
Computer Repair Request Form 

Fill out completely. Print TWO copies, one for the Help Desk, one for you.

Full Name: Status:

Campus Phone: Barnard email:


Computer Brand: If other, write:    

Laptop/desktop: Model:   Tag # // Serial Number:

Operating System: If other, write in:

Hard disk size: RAM: Password:

Hardware address (e.g. 00.0B.F7.04.5B.39):

DESCRIPTION OF THE PROBLEM:
 

USER STATEMENT: I own this computer. I use this computer for work related to my employment by Barnard.  I have backed up all documents, images and data. I understand that the Help Desk will attempt to repair this computer. The Help Desk staff may not be able to solve this problem.

I have given the Help Desk these separate parts, and they have been labeled.

Laptop Power cord Floppy drive CD drive Carrying case
(List other parts in description above)

I have delivered parts listed to Lehman Computer Center
Date: Time:

User's signature: ________________________________
Rec'd by:  ___________________

last update 01/23/06