TWU FMC Access Control Master or Grandmaster Key Request Form

Document Number: 1110.01-A FMC Division: Physical Plant

Page 1 of 1 1110.01 - A Revised by C. Williams 09.18.2019 X:\My Shared Folders\FacMgt\FACILITIES BUSINESS & SUPPORT SVC\POLICIES & PROCEDURES\University Regulations & Procedures_URPs\Forms & Procedures\1101.01_A FMC Sub_Master_GM Request Form_v2.docx

This document is submitted in accordance with TWU’s URP I.17.c and is submitted with the intent to assign the requested key as follows:

Building and Key Requested (Master or GM) Requestor Phone Number (incl. Area Code)

Name of Person Key Requested For Title of Person Key Requested For

TWU ID # of Key Requested For (Ex. 900123456) Email for Person Key Requested For

KEY ASSIGNMENT JUSTIFICATION * Unless FMC or DPS personnel, must list specific areas and rooms for which access is requested.

Requesting Key Holder (Signature) Date Signed

Departmental Authorizer (Printed Name) Departmental Authorizer Title

Departmental Authorizer (Signature) Date Authorized

Processed by (FMC staff) Date Processed

Signature - AVP, Facilities Mgmt, & Construction Date Authorized

Signature - VP, Finance & Administration (Required for Grandmaster) Date Authorized