Key/Keyless Entry Request Form
Please review the Employee Identification and Keys procedure prior to submitting this form
to the Director/Chief, Campus Police and Public Safety.
Date _______________________________ From _______________________________
☐ Check here if this request is for a keyless entry location (current employee ID/access card
required)
Employee Needing a Key or Keyless Entry Access
Name _______________________________________________________________________
Colleague Number ________________________ Extension ____________________________
Administrative Area ____________________________________________________________
Location of Key or Keyless Entry (Building/Room) ___________________________________
Budget Code (required for replacement keys, re-keying, etc.) _________________________
Employee Signature _____________________________________Date _________________
Supervisor Signature ____________________________________Date _________________
Dean/Department Head Signature _________________________Date _________________
Campus Police and Public Safety/Facility Services Use Only
Authorized by _____________________________________________
Date _________________
Key/Key Card Prepared by ____________________________________
Date _________________
Revised 1/2018
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