IT Service Request Form Full Name * Enter First and last name Username Your relationship with us ApplicantStudentStaff Student Number Please enter your 6 digit Student Number (If applicable) Phone Number Number we can reach you at (Home, Cell, or Extension) Email Address * Email address we can reach you at if you can't login to your Selkirk email Summary of Issue * Please provide a short description of your issue Web Address Please copy/paste the web address from your browser in this field if applicable. Description * Detailed description of your issue Spam Prevention Send Request Send Request Wait