Support Staff Request Form

Support Staff Request Form

Thank you for using this form. This allows for support tasks to be tracked and distributed to the appropriate staff.
Support Staff Roles
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Request Type

General Support Staff Request

After your request is submitted support staff will reach out to you.
Name

First NameLast Name
Email
example@example.com
Name of Project/Contract/Event etc.
Physical Location, Virtual, etc.
When do you need the support?
Ongoing, exact dates, deadlines, etc.
Details of Support Needed (please be as descriptive as possible, this will assist with supplying you with the correct and best support help; if there are meeting associated that support staff can join; other staff involved, etc.)

Order Request
- Please allow up to 48 business hours for an order to be placed.
- After you submit the form, you will recieve a copy of your request.
- Once the order has been placed, you will recieve a confirmation email with an estimated delivery date.
  - Please note this date may change. Any updates will be sent via email.
- Upon delivery, if items are missing, damaged, incorrect, etc. please email Erin Bachi as soon as possible.
Email
example@example.com
Code
Select Store/Vendor

Other
If ordering 1-2 items, please list links and quantities below:
If ordering 3 or more items, please attach a spreadsheet of your order details using the template below:

Cancelof
Ordering Template - Please Make A Copy
Deadline of when items are needed. (please keep in mind of shipping dates, delivery delays, setting up account etc.). ***Orders may take 2 weeks at minimum, for delivery of items.***
Location of Delivery/Drop Off

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Comments (if applicable)

Catering Request

Fill out a separate form for each meal (not each order). One week notice is required on all requests.
Email
example@example.com
Title of event/meeting requiring catering
Where should the food be delivered to?
Building name, address, room name/number, etc. Be as specific as possible; the more detail the better.
Code
Date of Catering

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Time order should be delivered or picked up

Hour Minutes

AM/PM Option
How many people is the catering for?
What vendor is being ordered from?
Vendor List
Pickup or Delivery?

Other
Dietary restrictions or allergies?
List order below (be as specific as possible. Provide names if the orders are specific to an individual)
Do you need plates, napkins, utensils?

Other
Comments/Notes:
Day of Contact Person: name, email, and phone number

Stipend/Per Diem Request
Email
example@example.com
Name

First NameLast Name
Documents Needed
Approved by
Project Name
Location of Event (City)
Coordinator
Code
Please indicate if it is a Stipend or Contract
Event Description
Stipend Dollar Amount
Date of Event

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of participation or date of event
Deadline of when you need stipend form

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Transport Request
Name

First NameLast Name
Email
example@example.com
Transport Item(s) and Description
Size, amount, temperature requirements, program, contract, etc.
Item's Current Location
Item's Final Location
Delivery Room Number or Person
(BHSSC Staff & Locations)
Item's Final Location (if not listed above)

Street Address

Street Address Line 2

CityState

Zip Code
Delivery Contact Name and Email

NameEmail
Date Available for Item Pickup

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Latest Date Needed for Delivery

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Directions, Questions, etc.

General Support Staff Request