Department of Public Safety - East Falls

Building Unlock/Lock Request Form

University Status

Faculty

Staff

Student

Department Making the Request

Organization's Name

Building & Room Number(s)

Event Contact

First Name:

Last Name:

Telephone (Primary):

Telephone (Emergency):

Email Address:

Event Information

Event Description:

Date of Event:

Time Event Begins, including pre-set up:

Time Event Ends, including clean-up/breakdown:

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