Submit a ticket : Parent Help Desk, Provided by FDLRS

Submit a ticket

I am:

<div class="control-group ticket_section">
                     <label class=" required control-label cf_name_2250139-label " for="helpdesk_ticket_cf_name_2250139"> Your First Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_name_2250139]" id="helpdesk_ticket_custom_field_cf_name_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_last_name_2250139-label " for="helpdesk_ticket_cf_last_name_2250139">Your Last Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_last_name_2250139]" id="helpdesk_ticket_custom_field_cf_last_name_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_phone_number_2250139-label " for="helpdesk_ticket_cf_phone_number_2250139">Phone Number</label>
            <div class="controls   ">
              <input class="  number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_phone_number_2250139]" id="helpdesk_ticket_custom_field_cf_phone_number_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_county_2250139-label " for="helpdesk_ticket_cf_county_2250139">County Where Child attends (or will attend) School</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_county_2250139]" id="helpdesk_ticket_custom_field_cf_county_2250139"><option value="">...</option>
<option data-id="72000521662" value="Alachua">Alachua</option>
<option data-id="72000521663" value="Baker">Baker</option>
<option data-id="72000521664" value="Bay">Bay</option>
<option data-id="72000521665" value="Bradford">Bradford</option>
<option data-id="72000521666" value="Brevard">Brevard</option>
<option data-id="72000521667" value="Broward">Broward</option>
<option data-id="72000521668" value="Calhoun">Calhoun</option>
<option data-id="72000521669" value="Charlotte">Charlotte</option>
<option data-id="72000521670" value="Citrus">Citrus</option>
<option data-id="72000521671" value="Clay">Clay</option>
<option data-id="72000521672" value="Collier">Collier</option>
<option data-id="72000521673" value="Columbia">Columbia</option>
<option data-id="72000521674" value="DeSoto">DeSoto</option>
<option data-id="72000521675" value="Dixie">Dixie</option>
<option data-id="72000521676" value="Duval">Duval</option>
<option data-id="72000521677" value="Escambia">Escambia</option>
<option data-id="72000521678" value="Flagler">Flagler</option>
<option data-id="72000521679" value="Franklin">Franklin</option>
<option data-id="72000521680" value="Gadsden">Gadsden</option>
<option data-id="72000521681" value="Gilchrist">Gilchrist</option>
<option data-id="72000521682" value="Glades">Glades</option>
<option data-id="72000521683" value="Gulf">Gulf</option>
<option data-id="72000521684" value="Hamilton">Hamilton</option>
<option data-id="72000521685" value="Hardee">Hardee</option>
<option data-id="72000521686" value="Hendry">Hendry</option>
<option data-id="72000521687" value="Hernando">Hernando</option>
<option data-id="72000521688" value="Highlands">Highlands</option>
<option data-id="72000521689" value="Hillsborough">Hillsborough</option>
<option data-id="72000521690" value="Holmes">Holmes</option>
<option data-id="72000521691" value="Indian River">Indian River</option>
<option data-id="72000521692" value="Jackson">Jackson</option>
<option data-id="72000521693" value="Jefferson">Jefferson</option>
<option data-id="72000521694" value="Lafayette">Lafayette</option>
<option data-id="72000521695" value="Lake">Lake</option>
<option data-id="72000521696" value="Lee">Lee</option>
<option data-id="72000521697" value="Leon">Leon</option>
<option data-id="72000521698" value="Levy">Levy</option>
<option data-id="72000521699" value="Liberty">Liberty</option>
<option data-id="72000521700" value="Madison">Madison</option>
<option data-id="72000521701" value="Manatee">Manatee</option>
<option data-id="72000521702" value="Marion">Marion</option>
<option data-id="72000521703" value="Martin">Martin</option>
<option data-id="72000521704" value="Miami-Dade">Miami-Dade</option>
<option data-id="72000521705" value="Monroe">Monroe</option>
<option data-id="72000521706" value="Nassau">Nassau</option>
<option data-id="72000521707" value="Okaloosa">Okaloosa</option>
<option data-id="72000521708" value="Okeechobee">Okeechobee</option>
<option data-id="72000521709" value="Orange">Orange</option>
<option data-id="72000521710" value="Osceola">Osceola</option>
<option data-id="72000521711" value="Palm Beach">Palm Beach</option>
<option data-id="72000521712" value="Pasco">Pasco</option>
<option data-id="72000521713" value="Pinellas">Pinellas</option>
<option data-id="72000521714" value="Polk">Polk</option>
<option data-id="72000521715" value="Putnam">Putnam</option>
<option data-id="72000521716" value="St. Johns">St. Johns</option>
<option data-id="72000521717" value="St. Lucie">St. Lucie</option>
<option data-id="72000521718" value="Santa Rosa">Santa Rosa</option>
<option data-id="72000521719" value="Sarasota">Sarasota</option>
<option data-id="72000521720" value="Seminole">Seminole</option>
<option data-id="72000521721" value="Sumter">Sumter</option>
<option data-id="72000521722" value="Suwannee">Suwannee</option>
<option data-id="72000521723" value="Taylor">Taylor</option>
<option data-id="72000521724" value="Union">Union</option>
<option data-id="72000521725" value="Volusia">Volusia</option>
<option data-id="72000521726" value="Wakulla">Wakulla</option>
<option data-id="72000521727" value="Walton">Walton</option>
<option data-id="72000521728" value="Washington">Washington</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_preferred_method_of_contact_2250139-label " for="helpdesk_ticket_cf_preferred_method_of_contact_2250139">Preferred Method of Contact</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_preferred_method_of_contact_2250139]" id="helpdesk_ticket_custom_field_cf_preferred_method_of_contact_2250139"><option value="">...</option>
<option data-id="72000555051" value="Email">Email</option>
<option data-id="72000555052" value="Phone Call">Phone Call</option>
<option data-id="72000555053" value="Either">Either</option></select>
            </div> 
                  </div>

<div class="control-group ticket_section">
                     <label class=" required control-label cf_ticket_submitter_name_2250139-label " for="helpdesk_ticket_cf_ticket_submitter_name_2250139">Ticket Submitter Name</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ticket_submitter_name_2250139]" id="helpdesk_ticket_custom_field_cf_ticket_submitter_name_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_ticket_status_2250139-label " for="helpdesk_ticket_cf_ticket_status_2250139">Ticket Status</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_ticket_status_2250139]" id="helpdesk_ticket_custom_field_cf_ticket_status_2250139"><option value="">...</option>
<option data-id="72000701347" value="Ticket is ready to be resolved">Ticket is ready to be resolved</option>
<option data-id="72000701348" value="Ticket is waiting on a FDLRS Employee to Respond">Ticket is waiting on a FDLRS Employee to Respond</option>
<option data-id="72000701349" value="Ticket is waiting on a 3rd party to respond">Ticket is waiting on a 3rd party to respond</option>
<option data-id="72000701370" value="Ticket is waiting on parent/family member for more details or information">Ticket is waiting on parent/family member for more details or information</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                      <div class="controls">
            <label class="checkbox ">
              <input name="helpdesk_ticket[custom_field][cf_field_entry_directions_2250139]" type="hidden" value="0" /><input class="  checkbox section_field" id="helpdesk_ticket_custom_field_cf_field_entry_directions_2250139_72000701336" type="checkbox" value="1" name="helpdesk_ticket[custom_field][cf_field_entry_directions_2250139]" /> I understand that the remaining questions pertain to the parent, family and child.
            </label>
          </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_parentfamily_member_first_name_2250139-label " for="helpdesk_ticket_cf_parentfamily_member_first_name_2250139">Parent/Family/Community Member First Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_parentfamily_member_first_name_2250139]" id="helpdesk_ticket_custom_field_cf_parentfamily_member_first_name_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_parentfamily_member_last_name_2250139-label " for="helpdesk_ticket_cf_parentfamily_member_last_name_2250139">Parent/Family/Community Member Last Name</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_parentfamily_member_last_name_2250139]" id="helpdesk_ticket_custom_field_cf_parentfamily_member_last_name_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_preferred_method_of_contact670432_2250139-label " for="helpdesk_ticket_cf_preferred_method_of_contact670432_2250139">Preferred Method of Contact</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_preferred_method_of_contact670432_2250139]" id="helpdesk_ticket_custom_field_cf_preferred_method_of_contact670432_2250139"><option value="">...</option>
<option data-id="72000711412" value="Email">Email</option>
<option data-id="72000711411" value="Phone Call">Phone Call</option>
<option data-id="72000711413" value="Either">Either</option>
<option data-id="72000711414" value="Unknown">Unknown</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_phone_number_2250139-label " for="helpdesk_ticket_cf_phone_number_2250139">Phone Number</label>
            <div class="controls   ">
              <input class="  number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_phone_number_2250139]" id="helpdesk_ticket_custom_field_cf_phone_number_2250139" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class=" required control-label cf_county_2250139-label " for="helpdesk_ticket_cf_county_2250139">County Where Child attends (or will attend) School</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_county_2250139]" id="helpdesk_ticket_custom_field_cf_county_2250139"><option value="">...</option>
<option data-id="72000521662" value="Alachua">Alachua</option>
<option data-id="72000521663" value="Baker">Baker</option>
<option data-id="72000521664" value="Bay">Bay</option>
<option data-id="72000521665" value="Bradford">Bradford</option>
<option data-id="72000521666" value="Brevard">Brevard</option>
<option data-id="72000521667" value="Broward">Broward</option>
<option data-id="72000521668" value="Calhoun">Calhoun</option>
<option data-id="72000521669" value="Charlotte">Charlotte</option>
<option data-id="72000521670" value="Citrus">Citrus</option>
<option data-id="72000521671" value="Clay">Clay</option>
<option data-id="72000521672" value="Collier">Collier</option>
<option data-id="72000521673" value="Columbia">Columbia</option>
<option data-id="72000521674" value="DeSoto">DeSoto</option>
<option data-id="72000521675" value="Dixie">Dixie</option>
<option data-id="72000521676" value="Duval">Duval</option>
<option data-id="72000521677" value="Escambia">Escambia</option>
<option data-id="72000521678" value="Flagler">Flagler</option>
<option data-id="72000521679" value="Franklin">Franklin</option>
<option data-id="72000521680" value="Gadsden">Gadsden</option>
<option data-id="72000521681" value="Gilchrist">Gilchrist</option>
<option data-id="72000521682" value="Glades">Glades</option>
<option data-id="72000521683" value="Gulf">Gulf</option>
<option data-id="72000521684" value="Hamilton">Hamilton</option>
<option data-id="72000521685" value="Hardee">Hardee</option>
<option data-id="72000521686" value="Hendry">Hendry</option>
<option data-id="72000521687" value="Hernando">Hernando</option>
<option data-id="72000521688" value="Highlands">Highlands</option>
<option data-id="72000521689" value="Hillsborough">Hillsborough</option>
<option data-id="72000521690" value="Holmes">Holmes</option>
<option data-id="72000521691" value="Indian River">Indian River</option>
<option data-id="72000521692" value="Jackson">Jackson</option>
<option data-id="72000521693" value="Jefferson">Jefferson</option>
<option data-id="72000521694" value="Lafayette">Lafayette</option>
<option data-id="72000521695" value="Lake">Lake</option>
<option data-id="72000521696" value="Lee">Lee</option>
<option data-id="72000521697" value="Leon">Leon</option>
<option data-id="72000521698" value="Levy">Levy</option>
<option data-id="72000521699" value="Liberty">Liberty</option>
<option data-id="72000521700" value="Madison">Madison</option>
<option data-id="72000521701" value="Manatee">Manatee</option>
<option data-id="72000521702" value="Marion">Marion</option>
<option data-id="72000521703" value="Martin">Martin</option>
<option data-id="72000521704" value="Miami-Dade">Miami-Dade</option>
<option data-id="72000521705" value="Monroe">Monroe</option>
<option data-id="72000521706" value="Nassau">Nassau</option>
<option data-id="72000521707" value="Okaloosa">Okaloosa</option>
<option data-id="72000521708" value="Okeechobee">Okeechobee</option>
<option data-id="72000521709" value="Orange">Orange</option>
<option data-id="72000521710" value="Osceola">Osceola</option>
<option data-id="72000521711" value="Palm Beach">Palm Beach</option>
<option data-id="72000521712" value="Pasco">Pasco</option>
<option data-id="72000521713" value="Pinellas">Pinellas</option>
<option data-id="72000521714" value="Polk">Polk</option>
<option data-id="72000521715" value="Putnam">Putnam</option>
<option data-id="72000521716" value="St. Johns">St. Johns</option>
<option data-id="72000521717" value="St. Lucie">St. Lucie</option>
<option data-id="72000521718" value="Santa Rosa">Santa Rosa</option>
<option data-id="72000521719" value="Sarasota">Sarasota</option>
<option data-id="72000521720" value="Seminole">Seminole</option>
<option data-id="72000521721" value="Sumter">Sumter</option>
<option data-id="72000521722" value="Suwannee">Suwannee</option>
<option data-id="72000521723" value="Taylor">Taylor</option>
<option data-id="72000521724" value="Union">Union</option>
<option data-id="72000521725" value="Volusia">Volusia</option>
<option data-id="72000521726" value="Wakulla">Wakulla</option>
<option data-id="72000521727" value="Walton">Walton</option>
<option data-id="72000521728" value="Washington">Washington</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_date_call_or_email_was_received_2250139-label " for="helpdesk_ticket_cf_date_call_or_email_was_received_2250139">Date Call Or Email Was Received</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_date_call_or_email_was_received_2250139]" id="helpdesk_ticket_custom_field_cf_date_call_or_email_was_received_2250139" />
            </div> 
                  </div>

Child First Name

Child Last Name

Age of Child

What is your reason for contacting FDLRS?

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Do you need any accommodations during this ticket process? (i.e. large print, hearing impairment)

Email Address

Have you contacted your child's school or school district about this issue?

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