(Please print, sign, and date before submitting the original to
University Police)
Prior to submitting
this form to the Police Department, ensure that you have a current
work assignment posted in PeopleSoft or have a pink slip from Human
Resources to verify employment at the time of request. Upon receipt
of a COMPLETED key request, the key(s) will be issued within
16 business hours.
LAST NAME:
FIRST:
MI:
Office Ext:
UHCL ID#: (7 digits)
<-----OR----->
Driver's License #
Department/extension:
Personnel Type:
KEY WILL BE RETURNED AT THE END OF...
Personnel Status:
OR specific date:
Example:
B1510-2
Room #
Room #
Room #
Room #
Room #
Room #
Room #
Room #
NOTE: (Use room number boxes to
specify DESK & FILE CABINET LOCKS as well.
Key number is obtained from the front of the lock in most cases.)
(Signature of
REQUESTOR and Date)
(Signature of
DEAN/DIRECTOR/DESIGNATE and Date) **
** Key Requests are honored when properly signed by
authorized individuals only. All others will be
returned. When requesting access to an office inside a suite,
access to that suite will not be given unless the suite number is
specified as well.
