EECS Key and Cardkey Request Form

The key request form must be sent by a FACULTY or STAFF member. Everyone (except Faculty/Staff) is required to pay a $5.00 deposit for each key and $20.00 for cardkey. Questions regarding key and cardkey access can be sent to keys@eecs.

Pending Department approval, key and cardkey request will be confirmed via email before issuance.

The Building Emergency Plan (BEP) and Illness & Injury Prevention Program (IIPP) review is required prior to any access being granted.

The information below applies to the faculty/staff member who is requesting the key:

Your Name (Last, First, MI):

Your E-mail Address:

The information below applies to the person for whom the key is being requested:

Has the person for whom access is being requested reviewed the Soda or Cory BEP/IIPP information above? yes  no

Name (Last, First, MI):

E-mail Address:

Work Address:

Work Phone#:   Home Phone#:

If Other Graduate, please specify



Reason for Access:

Duration of Use:

If he/she already possesses a CAL ID proximity card or WHITE card key, please provide the following information:

    • for CAL ID proximity card (back of card) - either first or last SET of 5-6 numbers
    • for WHITE card key - either printed or written number

Should this person be added to the EECS Roster?   yes  no

Would this person need a mailbox?   yes  no

Faculty Sponsor

Name (Last, First, MI):

E-mail Address: