Access Request Form (for JFB, South Physics, and INSCC)


Personal Information Name : (First Last) I am a UCard ID # (8 digits): UCard MagStripe # : 9840 0000 UCard CCure # (required for INSCC, located on back of card): 2 Contact (Email or Phone or Address) : Why do you need access and who will be supervising/be responsible for the activity for which you need access? :
What access do you want? South Physics Entrances (Please read Agreement) I have read the agreement and I accept the terms and conditions. Computer Lab, SP 205 Computer Lab, JFB 210 (Graduate students only) Electronics Lab, SP 302 (Students of Electronics class only) Machine Shop (Take the shop course first) Wood Shop (Take the shop course first) Stockroom (Must provide account information) Copy Machines (Must provide account information) Liquid Nitrogen (Please read Procedures and supply account information) I have read and understand the procedures and I agree to follow them. INSCC Entrances (Signed Access Form must be on file in main office ) I have read and understand the Key and Electronic Access form, I agree to observe it's terms, and I have delivered a signed copy of the form to the main office. INSCC Offices 205 - 240 INSCC Rooms 250, 262 & 266 INSCC 1st Floor Breakroom INSCC Conference Rooms, 3rd and 4th floors
Account Information Account Number (or Who pays the bill?) : If you are a TA, what classes are you TAing? Phycs , Phycs If you are a RA, PostDoc, or Visitor, who is your boss?

Please allow 2 to 3 days to process. If you do not have electronic access within 2 to 3 days, please send an email to rowleysd@physics.utah.edu.