Town Employee Maintenance Request Form

*This form is for Town of Lansing Employees only*

Date of Request:
Priority: *
Category: *
Department/Building: *
Please choose a department/building where maintenance is required. If it is a specific room or area please give details in "Description of Issue".
Myers Park Locations/Ludlowville:
Department of Public Works Locations:
Please include as much detail as possible, including exact locations and any helpful specifications, so Jordan can assist effectively.
Is this form completed? *