Information Technology Service Request

IT Service Request

Use this form to request IT Service on City Owned Equipment. Please complete all information including YOUR Name, Phone Number and E-mail Address so that someone can contact you if necessary. All information is needed, however the Contact Name, Email Address, Authorized Department Head and Desired Completion Date is required to submit the request. IT Requests, are limited to PC, Application, Network, Domain, or Telephone issues. A selection in one of these sections is required.
Date Submitted:	(mm-dd-yyy)
Contact Name (Req.):
Phone Number:	(505-966-####)
E-Mail Address (Req.):
Your Department Head (Req.):
Requesting Department (Req.):

Priority:	Low: Response; Two or More weeks.
	Medium: Response; One to Two weeks.
	High: Response; 24 to 48 hours.
Desired Completion Date (Req.):		(mm-dd-yyyy)

Requesting Service for a Workstation or Computing Device

Choose Operating System (Req.):

Windows XP Vista Windows 7 Server 2000 Server 2003 Server 2008 Other:

IF the request for service is on the Workstation or digital device: Choose the Workstation/Hardware/Security issue first then the application from the dropdown list. Leave these selections blank if the issue is a network or telephone service request. If you do not see your selection listed on ANY of the dropdowns, then enter your issue in the "Other" field provided opposite the appropriate request. THIS SECTION IS NOT FOR NETWORK OR TELEPHONE ISSUES.

Workstation/Hardware/Security:	Other:
Application:	Other:
The following information is necessary, when support needs to "remote" to your PC or computing device. The PC name is located in System Properties by right clicking "My Computer" on the Desktop and clicking Properties and looking under the Computer Name Tab. It is usually in the "ch-xx-##" format. Enter the time that the PC is available for access over the network. Remember the PC must be ON for support to access the computer. If support needs access to your domain profile, your password is required, otherwise your password will be reset to the default.
Full Computer Name : (bb-xx-##) Times for Remote Logon: (hh:mm am/pm)

Requesting Service for Network or Telephone Services
IF the issue is Network or Telephone related, then complete this section. Choose a Network or Telephone issue from the dropdown lists below. Choose only one issue either Network or Telephone. If you do not see your selection listed on the appropriate dropdown, then enter your issue in the "Other" field provided opposite the appropriate issue. Please include a narrative in the Objective field. Be as concise as possible so as not to delay your request. You will be contacted for clarification if necessary. USE THIS SECTION FOR WEBSITE UPDATES CHOOSE "WEBSITE UPDATE" UNDER NETWORK DROP DOWN.
Network:	Other:
Telephone:	Other:

Objective:
Justification: