Public Safety : Card Access Request

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Card Access Request

Contact Information of the cardholder

Please make sure you have filled in all required fields with valid information.

First Name:

Last Name:

Email:

Classification:

Student Classification:

Department:

RamNet ID #:

Add the 5 digit numbers starting with 6A* or 6B* XXXXX on back of card:

Contact Phone Number:

- Phone (next 3 digits): - Phone (next 4 digits):

Request Information

Please make sure you have filled in all required fields with valid information.

Type of Request:

Campus:

Building:

Other Building:

Floor:

Other Floor:

Room Number:

Request Start Date:

Request Start Time:

Request End Date:

Request End Time:

Purpose of Request:

Approver Information

Please make sure you have filled in all required fields with valid information.

Approver must be AVP, Building Administrators, Deans, Directors, Associate Directors, Managers, and Supervisors to authorize clearances. Students must see their Res Hall Housing Administration for approval.

Approver Email:

Approver First Name:

Approver Last Name:

Approver Contact Number:

- Phone (next 3 digits): - Phone (next 4 digits):

Approver Date:

Approver Time:

For bulk lists please make sure it is in CSV format Excel spreadsheet and email to: Electronic Security dps-essupport@wcupa.edu, along with WORKORDER number in the subject line.