You must have JavaScript enabled to use this form. Employee Information Employee’s Name Employee ID No. Division/Department Manager: GBC Email: College Main Locations: Please issue above employee card access DURING/BEYOND NORMAL COLLEGE HOURS to the following: 200 King Street E 341 King Street E 193 King Street E 215 King Street E 230 Richmond Street E 300 Adelaide Street E 290 Adelaide Street E 63 Regent Park Blvd 51 Dockside Drive (Waterfront) 3 Lower Jarvis Street (The Daniels) 160 Kendal Avenue 1 Dartnell Avenue 146 Kendall Avenue Specific Information (Room numbers, as applicable), etc: Other Campus Buildings: Specify Building Location: Specific Room Numbers, as applicable, etc.: Check campus locations Issuance of Access CardStatementI understand and agree that the access card issued upon approval of this request is the property of the College and I further acknowledge responsibility and accountability for the card. I will report loss or theft of the card to the Access Control Specialist – Public Safety & Security immediately and to my department head. I also understand that the access card is issued for my exclusive use and may not be duplicated, loaned or used to allow any unauthorized person into a controlled area. I further understand and agree that my full cooperation will be expected during any investigation concerning a security matter that might have occurred in a controlled facility during a time when my presence in the facility has been recorded by the system. I further agree to remain knowledgeable of and abide by the College’s Access Control policy while in possession of the card, and I understand that any violations of this policy may result in revocation of access card use and/or disciplinary action. Employee’s Name Issue Date Approved: Division/Department Head Approval Date (1) Department Access Key Controller (DAKC) Approval Date (2) Public Safety & Security Manager Approval Date (3) Access Control Specialist Approval Date (4) Replacement Card Issued Employee’s Name Replacement Card Issue Date