Facilties Department
Key Request Form
Phone: 304-367-4110
Keys must be requested on the form and emailed to: Facilities@fairmontstate.edu
Name Phone:
Email:
Org:
Building:
Original Key Request
Lost Key Replacement
Room Number/Door(s) Key to Open: Damaged Key Replacement
Faculty
Staff
Student
Other
Individual Key Requested For:
Individual to Notify When Ready: Phone:
Campus Address:
Approved by Department Supervisor:
Date:
Keys Released To: Date:
I acknowledge receipt of the keys designated above. I agree not to allow or contribute to
the duplication of these keys. I understand it is my responsibility to return this key to the
University upon completion and/or termination of employment. I understand that it is my
responsibility to report any lost or stolen keys to the University immediately. I understand
and agree that violation of this agreement may render me responsible for the expenses of
a lock change for the affected areas.