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	MWSU \| Instructional Media Center	Classroom Equipment Trouble Report Form

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To report a problem that is a class time emergency please call classroom services at 271-4395.

Your Name:
Department:
Phone:	- -
Email:
Building location of problem:
Room number of problem:
Date of problem (MM/DD/YR):
Time of problem (HH:MM AM/PM):
Describe the problem(s) in detail:

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