SLCC Key Authorization
Request Form
   



 
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:  

   * Pick Up:     

    I will not duplicate key(s) under penalty of Utah Code Annotated, Sec. 63-9-22 1965 (Misdemeanor)
    I will return key(s) when my need or employment terminates, if lost or not returned I will pay the designated fee for each key.
    I understand violations of any of the above may lead to my suspension or termination from the college, as per SLCC policy and procedures.

   * 

Description:Description:

* Total number of keys authorized on this request: