Date: _________________
Employee Status:
(Check One)
FULL-TIME FACULTY
PERMANENT CLASSIFIED
ADMINISTRATOR
PART-TIME FA
CULTY
TEMPORAR
Y CLASSIFIED
OTHER:
__
________________
Page 1 of 2
Author: jpang
Revision: New-Key-Request-for-Room-Access-5-15-19
Berkeley City College
Business & Administrative Services
Request for Key & Smart Classroom Door Access
Issue keys/Smart Classroom access to: ___________________________, ___________________________
Print Name Last
First
TICKET request to Administrators for an Employee ID badge (Check one): New
Replacement
Employee Number (Required): ________________
Phone Number: _________________________ Email: _____________________________
Department: __________________________________ Job Title: ____________________________________
Smart Classroom (Employee Badge Access)
Fill in the last 4 digits of your employee badge number (back side): _________ Example: P37XXXX-X####
Select the room(s) you need badge access to:
014 015 031 032 033 034 052 053 054 055 125 126 212 213 214 216 218 224 311 315 316 321
322 323 513 521 522
Metal Keys requests for Non-Badge access offices and/or classrooms (continue on Page 2)
Approvals:
** Faculty requires 2 signatures: 1 signature from Dept Chair AND 1 signature from Dean/VPI or President **
Department Chair: ___________________________________ _____________________________________
(For Faculty) Print Name Signature Date
President / VP / Dean: _________________________________ ____________________________________
(For Faculty & Admin) Print Name Signature Date
1st Level Manager: ___________________________________ ____________________________________
(For Staff & Others) Print Name Signature Date
Example: 1 ####### (From HR)
For the Fillable Form go to http://www.berkeleycitycollege.edu (search for "Key Request")
*** IMPORTANT ***
For subsequent Smart Classroom access requests. DO NOT resubmit this form.
Faculty - Email John Pang at jpang@peralta.edu with approvals from Dept Chair and VP or Dean
Staff - Email John Pang at jpang@peralta.edu with approval from 1st Level Manager
The Email must include: The last 4 digits of the employee badge number (back side) & the Smart
Classroom number(s) requiring access.
Berkeley City College – Business Office
Initial each bullet to indicate that you have read and agree to follow the policies and procedures stated below
______Board Policy 3501 Campus Security & Access states that all district facilities will be closed to entry to
all non-police personnel during non-business hours. I agree to rem
ain off campus during non-business
hours unless I have written consent from the Director of Business & Administrative Services.
______Keys are the property of Peral
ta Community College District. I agree to return all keys and ID
electronic access cards at the termination of my employment.
______Part-Time Instructors & Counselors not returning in the subsequent semester must return keys to
the Business Office.
This will ensure that there will be enough keys available for new incoming PT faculties.
______Lost keys or ID access cards
will be reported immediately to the Business & Administrative Services
Office. I will report all lost or stolen keys or ID access cards immediately. I agree to pay the
following replacement fees for lost or stolen keys: Master Key - $60; Sub-Masters - $40;
Classrooms/Office - $20.
______Installing or changing locks and fabricating or duplicating keys is strictly prohibited. I agree to never
change locks or duplicate keys.
______All faculty and staff are responsible for maintaining building security. I agree to not prop doors
open or leave doors unlocked when rooms are not in use.
Key Issuance Procedures
Employee must date and initial when keys are issued and returned.
1. Keys will be issued by Berkeley City College – Business Office
2. Request for key & SC access form can be obtained from room 143 (hallway) or 4
th
floor wall form rack.
3. Forms must be signed (see Approvals”). Access will be approved on an “as needed” basis.
4. After obtaining signatures, Return completed form to Rm 141/143 Business Office, 1
st
Floor.
5. Business office requires up to 3 business days to review and process your request. If keys are not in
stock and must be made, you will be notified by the Business Office when they are delivered to us.
6. Keys can be picked up (With ID) in Rm 141/143 or the Cashier’ Office (Rm 153). Be sure to include
your contact information so you may be contacted when your request has been completed.
Tag #
Serial #
Core #
Date
Issued
Employee
Initial
Date
Returned
Employee
Initial
I agree to abide by these policies and procedures.
If I lose any keys I agree to pay a replacement fee as
stated above to Berkeley City College.
___________________________________ ___________________________________________
Employee name (print) Employee Signature Date
Page 2 of 2
Author: jpang
Revision: New-Key-Request-for-Room-Access-5-15-19
(Metal Keys ONLY)
Room No.
For the Fillable Form go to http://www.berkeleycitycollege.edu (search for "Key Request")
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