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Technology Request Form

Teacher Name: (Required)
Teacher E-mail: You are required to add Your Name@chs.srvusd.k12.ca.us in box. (Required)
Room Number: (Required)
Phone Number: (Required)
Check the appropriate box:
  1. This is an emergency Please fix today.
    Please answer all questions then hit the submit button located at the bottom of the page.
    Thank you
  2. Please fix as soon as possible.
    Please answer all questions then hit the submit button located at the bottom of the page.
    Thank you
The best time or Period to come:
The type of computer I have is:
Select the appropriate description that indicates the problem you are having:
Additional Information, Fill in only if you have an error message appear on your monitor screen:


After Clicking the Submit Button your message has been sent, you do not need to wait for a reply as long as you filled in all the required boxes.
If you are not sure you filled in all the information correctly please wait for the browser to process the information.
You will get a thank you message back if you filled the form out correctly.



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