Vending Issue

Please use this online form to request service or reimbursement for lost funds.

Machine Information
Please select the machine type.*
Please select the machine location.*
Please select the machine location.*
Please select the machine location.*
Indicate the service issue.*
- Machine accepting money and not vending product.
- Product stuck in machine.
- Machine not giving change.
- Card reader not accepting funds.
- Machine needs to be restocked.
- Other (please list more details below)
What type of card were you trying to use?*
- Phoenix Card
- Credit Card
- Debit Card
What product were you trying to purchase?*
Please include product and item #.
Please provide the dollar amount lost. (if applicable)
What type of funds were lost? (if applicable)
Please provide any additional information for this request.
Customer Information
Please complete the fields below so a reimbursement and/or service request can be processed accordingly.
Name*
First Last
Date Service Error Occurred*
MM slash DD slash YYYY
Email*
Phone
Campus Box #
0 of 5 max characters
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Machine Information