Fillable KEY REQUEST FORM 03272019 (West Georgia College)

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KEY REQUEST FORM 03272019 (West Georgia College)

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UWG ACCESS CONTROL KEY REQUEST FORM
This form must be completed by the employee’s supervisor or Departmental Access Coordinator (DAC). Please send
completed form to Facilities – Access Control or email to uwg_access_control@westga.edu
Access Control Management – UWG Procedure 7.3.1 Rev 1.5
GENERAL INFORMATION
CONTACT DATE
DEPARTMENT PHONE
ACCOUNT #
REQUEST TYPE
☐ NEW KEY ☐ DAMAGED/BROKEN KEY ☐ LOST KEY
BUILDING ROOM # QTY COST KEY MARK
TOTAL
KEYHOLDER INFORMATION
FIRST NAME LAST NAME
TITLE DEPT
UWG ID# (917) EMAIL
General Policy: The Access Control Manager will assign the lowest level of access to the individual’s card and/or key
credential. Physical keys that have to be created will incur a service charge and be charged to the department.
Members of the faculty, staff, students and non-collegiate employees who have been issued keys must agree not to loan,
duplicate, or hand-off keys to anyone for any reason. Violation may cause disciplinary action up to termination from
employee and re-imbursement for all associated costs.
All lost keys must be reported immediately to University Police, Department Head, and Access Control.
SUPERVISOR/DAC
PRINT NAME
SUPERVISOR/DAC
SIGNATURE
DATE
ACCESS
CONTROL
NOTES
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KEY REQUEST FORM 03272019 (West Georgia College)

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Completed 23 July 2020

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