Student Repair Request Form
Please give us 3 business days to run diagnostic testing, provide needed installations and address virus issues.
Reason you're bringing in your computer
Received computer through one of these programs
DO/MBA or other MBA
None of the Above
Win 8 / 8.1
Not Sure / Other
Username/Password - Windows information to get in the computer
Computer Make / Model#
Computer Service Tag or Serial Number
Power Cord Provided
I release, waive and discharge Rockhurst and RUCS personnel from any of all liability (financial or otherwise) resulting from any assistance, work, repair or other services provided to me. I acknowledge that Rockhurst and/or RUCS is not responsible for damages to or loss or corrupution of hardware, software, data, information or other files stored on my computer. I represent that I own or have express permission to use this computer and I do us this computer at RU.
I give RU and RUCS permission to work on my computer
Do Not Fill This Out