Maintenance Repair Form

This is for facility maintenance only -- i.e. Buildings, Electrical, Plumbing etc.

Please fill out the form below:

What type of problem are you experiencing?

Department Location

Enter your comments in the space provided below and include as much detail as possible:.

Tell us how to get in touch with you:

Name:
E-mail:
Tel:
Please contact me as soon as possible regarding this matter.


Richard Mendoza, Technology Coordinator
Copyright © 2005  Ho`ola Lahui Hawai`i. All rights reserved.
Revised: 03/13/08.