飲水機、教室、會場維修及校園清潔通報 Water Dispenser, Classroom, Meeting Room Maintenance and Campus Cleaning Report Form

*姓名 Name:

身份別 Identity:

學號 Student ID:

請務必填寫正確 Please ensure that every field is filled in correctly

*單位或系別 Unit or Department:

例：工程學院工程所 For example: College of Engineering

*連絡電話 Contact Number:

請務必填寫，以利通知緊急事項 Please ensure that the information is accurate so that you receive urgent notifications

*Email:

請務必填寫正確，本組將透過E-mail通知相關訊息 Please ensure that the information is accurate; we will send notifications by email

*通報事項 Maintenance problems:

選擇通報項目 Please select the problem requiring maintenance

*地點（或編號）Location (or serial number):

請填寫故障或清潔地點，如飲水機，請填寫地點或飲水機上標示編號，如教室或會議室，請填教室或會議室編號IB-303 Please describe the malfunction or the location to be cleaned. For example, for a water dispenser, please write the location of the water dispenser or the serial number of the water dispenser; for a classroom or conference room, please provide the room number, such as IB-303.

故障原因或清潔事項 Malfunction report or cleaning required:

*驗證碼

驗證碼語音播放器