Valdosta State University Key Request Form


Last Name
First Name
Middle Int.
Date of Request

Department
Title
Phone #
Building Room Keycode Blank#
Purpose for key request:

Electronic Access Request: (Attach a separate sheet of paper if needed for the electronic access request)

Building and Location


Last Name
First Name
M.I.
VSU ID#
Access Times

Last Name
First Name
M.I.
VSU ID#
Access Times

Dept. Head Approval
Date

Secondary Approval
Title
Date

Employee Signature: _______________________________ Date: _______________

(To be signed when key is picked up. Not required for Electronic Access.)

Note: Replacement cost:
Single Operator key = $25, Sub Master Key = $250, Building Master = $500, Grand Master = $1000

Instructions for obtaining approval:
Secondary approval must be obtained when requesting Building Master and Grand Master Keys. Building Masters and Grand Masters require the signature of the Vice President for Finance & Administration. Route all key requests to Plant Operations Work Management section.

*Note* All keys must be obtained from and returned to the Key Control Shop. No transfers between individuals will be authorized.

(Submit this form in duplicate)