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Enter a Service Request
 
 

Service Request 
If you are here to report a fire, gas leak or any other life-threatening emergency, do not complete this form. Dial 911 immediately. Otherwise, please complete this form including the machine identification number, address and zip code where the machine is located and a brief description of the problem you are experiencing.

Fields with a star (*) are required.
Contact Information:

First Name*: 

Last Name*: 

Your Phone Number: 

Your Email Address: 
 
Service Location:

School Name*: 
 

Example: Purdue University (No Abbreviations)

City*: 

State*: 

Zip Code: 

Residence Hall or Address*: 

Floor: 
 

Examples: Jester Residence Hall or 1234 Main Street

(If reporting more than one laundry room address, please enter the additional addresses in the Comments)
Machine Identification:
 

Machine Type*

Problem Code*

Machine ID

Machine 1*: 
 -

Machine 2: 
 -

Machine 3: 
 -

Machine 4: 
 -

Machine 5: 
 -

Machine 6: 
 -
 

Machine ID Example:
Comments: Please provide a brief description about the additional locations of the machines that need service and their problems

 
 

Do not enter refund information within the comments as it will not be processed. Please check the refund procedure at your residence hall or call ASI Customer Service at 1-800-762-3452.
                
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