Technology Services Request Form

Welcome, Members of the Educational Service Unit #13 If your computers, peripherals or network is not running at 100% we can help. Just complete the Form below and we can arrange for our Computer Technician to come out and fix your problems. Our callout fees start at $35 / hour. For complete Pricing contact ESU13 tech department at (308)-635-3696

* Indicates a Required field

School Name	*
Department	*
Your Full Name	*
Room #	*
Phone #	*
E-Mail Address	*
Confirm E-Mail	*
Date MM/DD/YY	*
Description of the problem or your request	*

Item Description
Model #
Serial #
Brand Name