Key Request Form

SANTA BARBARA CITY COLLEGE
AUTHORIZATION TO ISSUE KEYS
KEY HOURS: 8:30-11:30am, 1:30-3:30pm
BUILDING: WC-4

*Please clearly print and complete all information
Name (Print) ______________________________
Home Address_____________________________
Home Phone_______________________________
Work Phone_______________________________
New Employee Y N
Certificated		Classified
Hourly_______		P/T Permanent_______
Contract_____		F/T Permanent________
Employee in ______________________, please issue the following keys:
(Department)
Building________________________________Room___________________
Other Areas_____________________________________________________
Key Number_____________________________________________________
Cabinet/File/Padlock______________________________________________
I acknowledge receipt of the listed keys, and agree to use them strictly in accordance
with my employment at SBCC.My signature indicates agreement that, with due
process, SBCC can withhold from my pay an amount necessary to replace/rekey the facility in the event I lose or misplace my keys.I also understand that I am personally responsible for these keys and agree to return them to the Purchasing Department upon termination of my employment.
Signed_________________________________________________________
(Employee)
Approved_______________________________________________________
(Department Head/Dean/Vice President)
Issued Date_____________
ACT Entered Date________
Returned Date___________
ACT Entered Date________

*Board Approved District policy no keys are issued to temporary hourly Classified staff or students.

Purchasing