Maintenance or Custodial Work Request

The Church of St. Gerard Majella
9600 Regent Avenue North
Brooklyn Park, MN 55443
763-424-8770

(NOTE: New work requires review and approval by the Parish Administrator.)

Requester
Name Name First Last
Phone Phone - ### - ### ####
Email
If you are a volunteer, which group are you working with?
Please indicate your staff liason:
Request
Date of Request: Date of Request: / MM / DD YYYY
Work Location:
Description of Work/Repair:
Timeframe
Timeframe (Check One):

Timeframe (Check One): Urgent When Possible By: By:

Maintenance or Custodial Work Request

Maintenance or Custodial Work Request

Requester

Request

Timeframe