Help Desk Chromebook Repair Ticket

Help Desk Chromebook Repair Ticket
Your Email*
example@example.com
Your Email (select from list)*
School Name*
Staff/Student Full Name
Student Grade*
***COMING SOON***

CHECK WHO BOUGHT INSURANCE HERE (Grades 4-12 only)

Worth Ave Group Flyer - ENG

Worth Ave Group Flyer - SPA
Does the Student Have Insurance?*
Is the damage Accidental or Mechanical?*
Insurance Company Wants to Know How the Accidental Damage Happened (Be as descriptive as possible)*
Damaged Chromebook Brand/Model*
Damaged Chromebook Serial Number*
Problem(s) With Chromebook*

Bottom Cover BrokenCamera IssueDisplay Bezel BrokenDisplay IssueFrame DamageHDMI Port IssueHeadphone Jack IssueHinge DamageKeyboard IssueMicrophone IssueMissing OS IssueOther (Describe Below)Palmrest Assembly BrokenRuns SlowRuns HotSpeakers IssueTop Cover BrokenTrackpad IssueUSB Port IssueWIFI IssueWon't ChargeWon't Power On
Description of Chromebook Issue*
Take Photo of Damage 1 (must have a web cam)
Take Photo of Damage 2 (must have a web cam)
Take Photo of Damage 3 (must have a web cam)
Replacement device is

PermanentLoaner
Replacement Device Brand/Model
Replacement Device Serial #
Replacement Device Issued On:

MonthDayYear
Date
Should be Empty: