Key Request Form

Please complete all fields on this form. You will receive an email confirmation with instructions on key pickup within 3 business days.

 
 

Last name, First name

 
 
 
 
 
 
 

Separate multiple room numbers with a comma.

 

Check box only if this request is for a replacement key.

 

I acknowledge that I have read, understood, and agree to abide by the Department of Neuroscience Key Issuance Policy, in accordance with The University’s Key Control and Accountability Policy.