Bloomsburg University

Building and Door Access Request
(Key/Card Access and Core Change)
Request Date:

REQUESTOr Information

Requestor Name: / Employee ID #:
Department: / Email: / Phone:
Campus Address: / SAP Cost Funds Ctr#:
Faculty Staff Graduate Student Permanent Employee Temporary Employee

ReQuest #1

Building Name: / Room # and/or Description:
Purpose of Request:
Select all that apply:
Key Request Key#
Core Change Request: Core# for change:
Card Access Request(categories): 24/7 Early Access Late Access
Saturdays from: to
Sundays from: to
Access on non-academics days
Expiration date for request:

ReQuest #2

Required Signatures

Department Chair/Director (Print): / Signature: / Date:
VP / Dean / Asst. Dean (Print): / Signature: / Date:
Key/Card Access Control OfficerRecommendation: / MWO#: / Date:
Asst. VP Facilities Management: Eric Ness / Signature: / Date:

Notification to requestor

Notification Date: / Notification Type: Email Phone

Key Pick-up / Received

Verify Key#(s): 
Name: (Print) / Signature: / Date:

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.

Direct card access authorization questions contact the Key Control Officer – 389-4542.

Fill out form with the requestor’s name, employee ID no., campus mailing address, department, cost fund center, phone no. Select faculty, staff, or graduate assistant. 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:

24/7Allows access 24 hours a day everyday*

Early AccessAllows access from 4am until the door automatically unlocks – weekdays only*

Late AccessAllows access from when the door automatically locks until 10pm – weekdays only*

Saturdays Allows access on Saturdays – indicate the time frames needed*

SundaysAllows 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 BuckinghamMaintenanceCenter.

4. Key/Card Access Control Officer will evaluate the request, make a recommendation, and forward the request to

the Asst. VP for Facilities Management.

5. The Asst. VP for Facilities Management 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 Asst. VP for Facilities

Management. .

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. Photo ID is required to receive the key(s).

Two keys/card access/core changes for the requestor may be requested on one request form. Keys will be issued only to the requestorand 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.

Key-Card Access Request Form Revised August 2015