Department Key Request Form Identification * Indicates a required field. uNID - (U of U Student, Staff or Faculty ID) * Name * Name First/Given First/Given Last/Family Last/Family Email * Position * Faculty Staff Student Other - Please describe belowOther - Please describe below Authorization Authorization Email - enter email of PI, professor, or supervisor * Room Type * Office Classroom Lab Other Before sending key delay inquiries to the facilities team, I will contact the above authorizing personnel to verify that they forwarded their approval. Key requests are only approved upon receipt of approval from the PI or Professor. * I understand Key Requested Key Requested * Select Location83 = JFB10 = South Physics19 = INSCC Room Number * Key Number Is this to replace a lost key? Yes Terms I acknowledge that I, the key requester, have read, reviewed, and understood ALL the conditions of key responsibility outlined in the University of Utah Key Policy 3-234, including the following: I am responsible for this key. I will NOT lend, transfer, or swap this key with anyone else, ever. I will return this exact same key to the main office (201 JFB) when my need or employment terminates. If my key number doesn't match the number in the department records, it is up to me to track down and return my original key. I understand any violations of any of the above will lead to forfeiture of my deposit, and/or 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. * Yes Special instructions or additional information 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 2 weeks 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. If you are human, leave this field blank. Submit Δ