Enter Service / Refund Request Ticket

*B.U. ID#*:

*First Name*:

*Last Name*:

Mailing Address:

P.O. Box:

City, State, Zip:

*Phone*:

*Email*:

Laundry Machine Location:

[Select Location] Babcock Street Beacon Street Buick Street Buswell Street Carlton Street Commonwealth Avenue Euston Street Harry Agganis Way Lower Bay State Road 56-179 Medical Campus Mountfort Street Park Drive Pilgrim Road Raleigh Street Riverway St. Mary Street Upper Bay State Road 180-212

Specific Street Address:

Machine Number:

[Select Location]

*Affected Machines*:

*Type of Problem*:

Coin Jammed in Machine. Machine is not registering money. Machine is not accepting Terrier Card. Machine is not starting Clothes are coming out of the machine wet Clothes are coming out soapy Water is leaking out of the machine Machine stopped during its regular cycle. Machine door will not open. The machine is abnormally noisy Dryer is not drying the clothes very well Dryer is too cold / no heat. Dryer is too hot The machine has been subject to vandalism. Dryer vent is not connected. Laundry room is dirty Other, See Below.

Problems:

Request Cash Refund:

Request Points Refund:

*Description of Problem*:
(If more than 1 machine is being reported please list each Machine Number & the problem associated with the specific Machine Number here)

*Indicates Required Field