Mansfield University of Pennsylvania
Developing Tomorrow's Leaders
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Carry-In Request Form

Take to Pinecrest Manor Room 100 or 102
Student Name:
Residence Hall & Room #:
Phone:
Serial # of Unit:
Today's Date:

Your explanation of the problem:
What Antivirus Software do you have?

What have you already tried to fix the problem?

Any Passwords on your computer?
Bios:

Windows:

TechConnect Staff Only
Received By:   Date Received:

Triage Report:

Next Steps Advised:

Returned to student:
Phone Call Date:
Email Date:       

 Pickup Date:
 Returned by:
 

 

 

 
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