Access Request
  1. Electronic Access Request Form for JFB, South Physics, & INSCC

  2. First/Given Name(*)
    Invalid Input
  3. Last/Family Name(*)
    Invalid Input
  4. I am a(n):(*)
    Invalid Input
  5. UCard ID# (8 digits)(*)
    Invalid Input
  6. UCard MagStripe# (8 digits): 9840 0000(*)
    Invalid Input
  7. C*Cure # (Located on back of Ucard. Only enter the numbers that appear BEFORE the space): 2*(*)
    Invalid Input
  8. Contact Email(*)
    Invalid Input
  9. Please state why you need access and who will be supervising/be responsible for the activity for which you need access?(*)
    Invalid Input. Please check that the field is filled in correctly.
  10. Building Access Agreement: The purpose of this agreement is to set forth the terms and conditions under which you are provided access to the Department of Physics & Astronomy buildings. The Physics & Astronomy Department reserves the right to terminate your access privileges at any time, with or without notice, for any reason. You will use the access privilege only for authorized activities and will take such steps as are reasonably necessary to prevent unauthorized use. You will be responsible for managing all persons using the secured facility under access provided by you. You accept financial liability for any loss of University property consequent to granting access, either directly or indirectly (e.g. by propping doors or disabling locks), to a person who does not have access permission. You will not share your access code with any other person. This Agreement shall be governed by the laws of the State of Utah.
  11. What Access Do You Want?

    (*)













    Invalid Input
  12. If you are a TA, what classes are you TAing?
  13. PHYS/ASTRO
    Invalid Input
      (i.e. "1010")
  14. PHYS/ASTRO
    Invalid Input
      (i.e. "1010")
  15. If you are an RA, PostDoc, or Visitor, who is your boss?
    Invalid Input
  16. Prove you're not a robot
    <small><b>Prove you're not a robot</b></small>
      RefreshInvalid Input
  17. 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 heidi@physics.utah.edu.
  18.   
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