Key Request Form

Key Request

Name of Requestor:
: Student Faculty Staff Other
Campus Phone #:
E-mail Address:: Note: Marywood e-mail address required.
Department:
Department Budget #:
Building key is requested for:

Room # key is requested for:

Number of keys requested
: (Note: only numbers can be entered into this box. Please use the box below for additional details.)
Was a key issued to you previously?
: Yes No
Does the key open any other room(s)?
: Yes No If yes, state room #(s):
Reason access is requested/additional details:

: A supervisor must approve this request. Marywood staff members should list their immediate supervisor. Faculty members should list their department chair. Students and others should list the faculty or staff member with whom this request is associated.
Supervisor's name:
Supervisor's e-mail:

2300 Adams Avenue, Scranton, PA 18509
570-348-6211 | toll free: 1-TO-MARYWOOD