Department Key Request Form
  1. IDENTIFICATION

  2. UnID#(*)
    Invalid Input. Please enter as "00123456" or "u0123456"
  3. First Name(*)
    Invalid Input
  4. Last Name(*)
    Invalid Input
  5. Position(*)




    Invalid Input
  6. Email(*)
    Invalid Input

  7. KEY REQUESTED

  8. Building #(*)
    Invalid Input
  9. Room #(*)
    Invalid Input
  10. Key #
    Invalid Input
  11. Is key lost?
    Invalid Input

  12. AUTHORIZATION

  13. Who is in charge of the rooms listed above?
    This request will be forwarded for approval before any keys are ordered.
  14. Room Type(*)




    Invalid Input
  15. Authorization Email(*)
    Invalid Input. Put "hsimpson@physics.utah.edu" if unsure.
  16. TERMS
    I acknowledge that I, the key requestor, understands the conditions of key responsibility outlined in the University of Utah Key Policy 3-234 including the following:
    • I will not lend this key.
    • I will return this key when my need or employment terminates.
    • I understand violations of any of the above will lead to my suspension or termination from the University of Utah.

    I have read, understood and acknowledge the conditions of key responsibility as outlined above. I agree to accept and abide by these terms & conditions.
  17. (*)
    Invalid Input

  18. Special Instructions or Additional Information
  19. Invalid Input
  20. PLEASE READ CAREFULLY & FOLLOW INSTRUCTIONS:
    Please bring $10 cash deposit per key when you pick up your key(s). If you are replacing keys that were lost, the deposit is $20 per key. We do not have change for large bills so please bring the exact amount (no checks, credit cards, coins or foreign currency accepted for key deposits). Your key(s) will be kept for 30 days and if not picked up will be returned to the key shop.

    • Keys will be ordered 1‐2 days following approval.
    • Key shop delivery is 3‐5 days after receipt of the order.
    • You will receive an email when the keys are available.
    • Pick up keys at the front desk (201 JFB).

    When you return your key(s) - your deposit will be returned to you.

  21. Prove you're not a robot
    <b>Prove you're not a robot</b>
    Invalid Input
  22.   
  • Department of Physics & Astronomy • 201 James Fletcher Bldg. 115 South 1400 East, Salt Lake City, UT 84112-0830
  • PHONE 801-581-6901
  • Fax 801-581-4801
  • ©2017 The University of Utah