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    FACILITIES SUPPORT

    Your Name

    Nature of defect/problem

    Your Facilities Support Request

    Location of defect/problem

    Brief Description

    Is malicious damage suspected? (To instigate CCTV check)
    NoYes

    Is this a Health and Safety near miss?
    NoYes

    Health and Safety Issue- Near Miss: Please explain:

    Other request (eg room/hall set up)

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