Access Request Form (for JFB, South Physics, and INSCC)

 
Personal Information
Name : (First) (Last)
I am a
UCard ID # (8 digits): UCard MagStripe # : 9840 0000
UCard C*Cure # (Located on back of card. Required: if you do not have this number you will need to obtain a new card from the Union Ucard office): 2*
Contact (Email) :
Why do you need access and who will be supervising/be responsible for the activity for which you need access? :
What access do you want?

JFB East Entrance
South Physics East Entrance

(Please read Agreement)

I have read the agreement and I accept the terms and conditions.
Computer Lab, SP 205
Electronics Lab, SP 302 (Students of Electronics class only)
Machine Shop, JFB 116 (Take the shop course first)
Wood Shop, JFB 117 (Take the shop course first)
Stockroom, JFB 114 (Must provide account information)
Copy Machines (Must provide account information)
Liquid Nitrogen (Please read Procedures and supply account information)
I have read and understand the procedures and I agree to follow them.
INSCC Entrances (Signed Access Form must be on file in main office )
I have read and understand the Key and Electronic Access form, I agree to observe it's terms, and I have delivered a signed copy of the form to the main office.
INSCC Offices 205 - 240
INSCC Rooms 250, 262 & 266
INSCC 1st Floor Breakroom
INSCC Conference Rooms, 3rd and 4th floors
Account Information
Account Number (or Who pays the bill?) :
If you are a TA, what classes are you TAing? Phycs , Phycs
If you are a RA, PostDoc, or Visitor, who is your boss?

 

 

Please allow 2 to 3 days to process. If you do not have electronic access within 2 to 3 days, please send an email to hsimpson@physics.utah.edu.