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BLOOMSBURG UNIVERSITY

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					BLOOMSBURG UNIVERSITY

Building and Door Access Request Form (Key/Card Access and Core Change) Date Requestor’s Name Department Telephone Number Campus Mailing Address Department Chair/Director
Choose one

Employee ID Number SAP Funds Center Staff Faculty Dean

Grad. Assistant

Student

1. Key Request Card Access Request Core Change Key No/Core No Building No Room No and/or Description Card Access Categories (check all that apply) 24/7 Early Access Late Access
Saturdays-from to Access on non-academic days? Sundays-from to

Expiration Date

Reason for Request 2. Key Request Card Access Request Core Change Key No/Core No Building No Room No and/or Description Card Access Categories (check all that apply) 24/7 Early Access Late Access
Saturdays-from to Access on non-academic days? Sundays-from to

Expiration Date

Reason for Request 3. Key Request Card Access Request Core Change Key No/Core No Building No Room No and/or Description Card Access Categories (check all that apply) 24/7 Early Access Late Access
Saturdays-from to Access on non-academic days? Sundays-from to

Expiration Date

Reason for Request Department Chair/Director Dean Key/Card Access Control Officer’s Recommendation Assist. VP for Administration Date Request Received Date Notification Sent Cancellation Date Key No Key Received By Key No Key Received By Key No Key Received By
Instructions on Next Page

Date Date Date Date MWO No Cancelled Date Date Date
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PROCEDURE This form is for requesting key, card access and core changes only. Should you need a new BU photo ID card, please contact the BU Card Center located in Elwell Hall.
1. Fill out form with the requestor’s name, employee ID no., campus mailing address, department, cost center, phone no. Select faculty, staff, grad. Assistant or student. Enter the name of department chair/director and Dean. Indicate the key, card access or core no. required, its location, room number and description and door number and the reason for the request. For card access controlled doors indicate the building number, description and which categories are to be activated. Note: access control locks that require the insertion of an ID card have 24/7 access only. Categories: What it does: 24/7 Allows access 24 hours a day everyday* Early Access Allows access from 4am until the door automatically unlocks – weekdays only* Late Access Allows access from when the door automatically locks until 10pm – weekdays only* Saturdays Allows access on Saturdays – indicate the time frames needed* Sundays Allows access on Sundays – Indicate the time frames needed* * - Access is granted during normal working days only during the academic year unless the “Access on non-academic day?” box is checked Access on non-academic days? – Indicate if the requestor is allowed access on days that the University is on a scheduled break or is not in session. 2. Submit form to the Department Chairperson/Director and Dean for approval. 3. Send form to the Key/Card Access Control Officer at Buckingham Maintenance Center. 4. Key/Card Access Control Officer will evaluate the request, make a recommendation, and forward the request to the area Assist. VP for Administration. 5. The Assist. VP for Administration will approve/disapprove the request and return the request form to the Key/Card Access Control Officer at the Buckingham Maintenance Center. 6. The Key/Card Access Control Officer will issue a M.W.O. if the request is approved by the Assist. VP for Administration. 7. Notification will be sent to the requestor once the key(s) or core changes are ready for pick-up. 8. Key(s) must be picked up by the requestor within ten (10) days after notification. Three keys/card access/core changes for the requestor may be requested on one request form. Keys will be issued only to the requestor and must remain in the possession of the requestor except as noted in the Key Control Policy or until they are returned to the Key Control Officer. Once card access is authorized per request, the card must remain in possession of the requested.

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