KEY REQUEST

(Please print, sign, and date before submitting the original to University Police)

Prior to submitting this form to the Police Department, ensure that you have a current work assignment posted in PeopleSoft or have a pink slip from Human Resources to verify employment at the time of request. Upon receipt of a COMPLETED key request, the key(s) will be issued within 16 business hours.

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LAST NAME: FIRST: MI: Office Ext:

UHCL ID#: (7 digits)

<-----OR----->

Driver's License #

Department/extension: 

Personnel Type: Select One Staff Faculty Student Visitor Contractor Temporary

KEY WILL BE RETURNED AT THE END OF...

Spring Summer Fall 2007 2008 2009 2010 2011 2012
Personnel Status: Full Time Part Time

OR specific date:

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Example:  B1510-2 Room # Room #
Room # Room # Room #
Room # Room # Room #

NOTE: (Use room number boxes to specify DESK & FILE CABINET LOCKS as well.
Key number is obtained from the front of the lock in most cases.)

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(Signature of REQUESTOR and Date)

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(Signature of DEAN/DIRECTOR/DESIGNATE and Date) **

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** Key Requests are honored when properly signed by authorized individuals only.  All others will be returned.  When requesting access to an office inside a suite, access to that suite will not be given unless the suite number is specified as well.