Date Student ID no. Student Name Department Phone number Email Keys Required Room No. Key No. Room No. Key No. Room No. Key No. Room No. Key No. Approver Email (Dean, Director or designate required for key access approval) Approver Email Acknowledgement I acknowledge that my student record will be put on hold and I will not have access to my transcript if the keys are not returned at the end of the access period. I acknowledge that a $50 fine will apply for lost or stolen keys. Leave this field blank