SLCC Card Access
Request Form
   



 
Requires: SLCC OneCard or SLCC Outside Agency I.D. Card
REQUEST MUST BE MADE 24 HOURS IN ADVANCE

   * First Name:      * Last Name:     * S# or ID#:

   * Home Address:      * City:     * State:     * Zip:    

   Work Phone:      Home Phone:      * Contact Phone:     

   * Email:        Mail Code: 

 

 * Dept:        *  Authorized By:  

   Campus:     

    I will notify the Key Office when access is no longer needed. I will not lend my OneCard to anyone.
    I will be charged a $20.00 reprogramming fee for my OneCard if lost or stolen.
    I understand any violation of the above may lead to my suspension or termination from the college, as per SLCC policy and procedures.

   * 


***Access May be Denied Without Prior Notification***

(24/7 Access Requires VP Approval)

  Desired Access:
  Example (Monday 8:00 a.m. - 12:00 p.m.)

Building Room#   Mon Tue Wed Thu Fri Sat Sun
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