ID - Key Card Access Form

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

Use this form to request a Badge and/or Hard Key(s) for a New or Existing Employee, an Authorized Contractor, Volunteer, etc. Once received, this form will be forwarded to the appropriate Department Approver(s). One Approver's reply will serve as authorizing signature. Approver may submit form to streamline workflow. Please allow approximately one week be notified that badge / key(s) are ready for pickup. Direct any questions to DL-PWD-Admins.
Requester's Information
You, the Requester, will notified via email when badge is ready for pick up. New cardholder's signature will be required upon pick up of badge and / or key(s).
 *
Requester's Information You, the Requester, will notified via email when badge is ready for pick up. New cardholder's signature will be required upon pick up of badge and / or key(s).
Employee / Cardholder Information
 *
Department
 *
Type of Badge / Access Request
 *
Type of Badge / Access Request
Hard Key Request
 *
Hard Key Request
Photo - REQUIREMENTS: Full face, with shoulders, on a solid background. REMINDER: Reprint requests for existing employees will incur a $10 fee, payable in cash at time of pickup, unless a department change applies.
Photo - REQUIREMENTS: Full face, with shoulders, on a solid background. REMINDER: Reprint requests for existing employees will incur a $10 fee, payable in cash at time of pickup, unless a department change applies.