Republic of the Philippines

Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF CANLAON CITY

2022-ICTU-

ICT UNIT SERVICE REQUEST FORM

Complete Name: DepEd Email:
School/Unit: Alternative Email:
Date: Contact Number:
Provision of Technical Assistance
☐ Face to Face with Virtual Participants
Event Details:
☐ Virtual
☐ Activity/Event
☐ Zoom Title:
Hosting/Technical
☐ Google Meet
Assistance Date/Time:
☐ MS Teams
☐ Face to Face No. of Participants:
Issues/Concerns:
☐ Hardware/Software ☐ Desktop ☐Laptop
Troubleshooting
☐ Printer ☐Others
☐ Request for Internet ☐ LAN ☐ Desktop ☐ Laptop ☐ Tablet ☐ Cellphone
Access ☐ WiFi MAC: MAC: MAC: MAC:
☐ Request for ID ☐ DepEd Last Name, First Name, Middle Name Blood Type: Employee No:
Requirement in softcopy: 2x2 ID
picture Scanned Signature
ID (ATM
Size) Designation: Contact No. in case of
☐ CSC Emergency:
Prescribed ID
☐ Video/Photo/ Details:
Graphics Layout

☐ Recorded Event
Meeting/ Title:
Details
Videos/Photos Date/Time: Platform used:

☐ Photo/video Event:
coverage Date/Time: Venue:
Details
Requirements:
Account Management
☐ DepEd Email ☐ Create Account Required Details:
☐ Office 365 ☐ Delete User
School ID:
☐ DepEd Commons ☐ Update User
☐ LMS ☐ Suspend User
Designation:
☐ DPDS ☐ Reset Password
☐ WINs ☐ Restore Data/Transaction Account Requested for:
☐ DTS ☐ Delete Transaction Employee Number (for DTS only)
☐Others, pls. specify: ☐ Edit Transaction
☐ Change Organizational Unit
☐ Change Role
Information Dissemination
NOTE: This request requires the initial of the Unit Head/School Head/Chief/ASDS and approval of the Schools Division Superintendent.
☐ Document Type ☐ Platform Details:
☐ News/Article ☐ Email Address Title:
☐ Request for Quotation ☐ Division Website
☐ Invitation to Bid ☐ Division FB Page Description/Caption:
☐ Announcement ☐ Division YouTube Channel
☐ Videos/Photos ☐ Smart TV
☐ Downloadable Forms ☐ Others, pls. specify: Attachment:
☐ Financial Reports
☐ Others, pls. specify:

Requested by: Recommending Approval: Approved:

___ _ _ _ _ _____ ___ _ _ _ _ _ _ _ _ __ ___ _ _______

Signature over printed Name (Unit Head/School Head/Chief) ASDS/SDS
FOR ICT UNIT USE ONLY
Date/Time Received: Received by:
Date/Time Completed: Service Provided by:
Remarks

Address: Lopez-Jaena St., Brgy. Mabigo, Canlaon City, Negros Oriental, 6223
Contact No.: (035) 415-1941 |+639178409286
Email Address:
Website: