Faculty & Staff Helpdesk Form

Contact Info
We ask for several different ways to contact you to make sure we can reach you.
Name*
First Last
LTC Email*
Personal Email
gmail, yahoo, etc. if needed
Department
Phone*
The best number to contact you or the person needing assistance, be it your office phone or a mobile number.
How do you prefer to be contacted?*
- Email
- Phone

Marketing Info
Marketing Request Type*
Marketing Event Date Info
Event Date
Date Format: MM slash DD slash YYYY
Event Start Time

: HH

MM
Event End Time

: HH

MM
Marketing Social Media Info
Please include who, what, when, why, where, call to action, etc.
Social Media Post Title
Social Media Post Details
Social Media File 1
Social Media File 2
Social Media File 3
Social Media File 4
Social Media File 5
Post Start Date
Date Format: MM slash DD slash YYYY
Post End Date
Date Format: MM slash DD slash YYYY
Marketing Product Info
Requested Due Date*
Date you must have the final product.
Date Format: MM slash DD slash YYYY
Non Social Media File

Request Info
Complete the information below as best as possible so we can provide the appropriate assistance.
Category
Campus/Building*
Other Location
Enter the location at which you are experiencing the issue. For example, at home, a hotel, etc.
Lab/Office
Enter the lab/office information.

Identity Verification
For us to better assist you, please answer 3 of the following questions so that we may verify your identity. Without this information, we cannot speak with you about your account.
Employee ID Number?
Month of Birth?
ZipCode?
Enter the zipcode for your personal address that should be on file with Human Resources.

ZIP Code
Personal Email
Enter a personal email that you have on file with Human Resources.
Supervisor Email
Enter your supervisor's email address.
Personal Phone
Enter a personal phone number you have on file with Human Resources.

Course Name
Detailed Information*
Include as much detail as you can. If this is a technical issue other than a request to reset your password, include specific steps to recreate the issue, the name of the software/website you are using, specific error messages, etc.
Name
This field is for validation purposes and should be left unchanged.

Contact Info