Request For Keys / Cat Card Access / Card De-Activation Complete fields and print from browser.  Obtain signatures. Mail or Fax completed form to: Physical Plant Department, 284 East Avenue, CPR SHOP FAX:  656-8537
Request Date:
Person who will be ISSUED key and/or Cat Card access:
Name:		PeopleSoft ID
Department:
Email Address:		Phone #:
University Address:		Activate___	Deactivate____
If applicable, who key/Cat Card access is from:
Name:		Effective Date
Brief description for key and/or lock change:
# of Keys	Building & Room #	Key #	Card Access? (Yes/ No)

Duration:Permanent Temporary.  If Temporary:  Return / Deactivation Date:

APPROVALS
Type/Print Dept. Chairperson's or Director's Name:	Signature- Dept. Chair/Director:	Date:
Type/Print Dean's Name:	Signature -Dean:	Date:
Type/Print Provost's Name (GM key):	Signature -Provost:	Date:
Type/Print Vice President's Name (GGM and GM key):	Signature -Vice President:	Date:

ISSUANCE OF KEYS

Key requestor will be e-mailed when keys are ready for pickup.  Key pick up at 284 East Avenue, Material Management Warehouse, Mon-Fri from 7:00 am - 12 noon and from 12:30 pm - 3:00 pm.  Recipient must show University I.D. and sign for keys, which acknowledges recipient will:    1. maintain security of any keys issued,    2. report the loss/theft of key(s) immediately to Police Services and Dept. Chairperson/Director, submit a new key request form for replacement, and pay for lost key, and    3. return all University keys, upon transfer/termination, to your Chairperson/Director.

SIGNATURE OF RECIPIENT:
Office Use Only.  Comments:
Keys Issued By:	Date:	Called:	Time: