University of Pennsylvania School of Medicine s1

PERELMAN SCHOOL OF MEDICINE AT THE UNIVERSITY OF This form is for PERIMETERS PENNSYLVANIA Only. SPACE PLANNING & OPERATIONS SECURITY DIVISION Revised 8/03 ACCESS KEY APPLICATION T

N Name: Last four digits of SS#: A C I

L Status: Existing Key holder New applicant P P

A (Employee U OF P): Department Name:

Faculty Staff D E

T Dept. Phone #: E L

P Lab/Office Phone #: M

O Student: C

E U OF P Medical Student Mail Box #: B

T Other (State school affiliation): Other (contractor, vendor, visitor, etc) Name & Organization: Phone #: Date: Signature: O

T This category includes all buildings listed below E

B 203 – SOM Perimeter Doors M

O Anatomy Chemistry Archway Johnson Lobby to Morgan

C Anatomy Chemistry West Entrance Johnson Elevator to Lobby T

E Anatomy-Chemistry South Entrance Johnson Elevator Lobby to Library

P Blockley Hall – 1 Floor Main Entrance Johnson Library to Elevator Lobby

D Blockley Hall Ground Floor Entrance Richards Main Entrance E

Y BRB II/III North Entrance Richards Rear Entrance B

I BRB II/III South Entrance Stellar-Chance Main Entrance S BRB II/III 1st Floor Elevator Lobby Stellar-Chance Elevator Lobby – 1st Floor U nd nd B BRB II/III 2 Floor Elevator Lobby Stellar-Chance 2 Floor Lobby S

S CRB Main Entrance Stemmler Main Entrance

E CRB Rear Entrance Stemmler Stair tower - Ground Floor N I CRB Loading Dock to Elevator Lobby Stemmler Stair tower – Basement M

D John Morgan Main Entrance Stemmler Basement to HUP

A Stemmler Sub-basement T

S Stemmler Tower to Rhoades Pavilion I N T A R R O S

N Applicant’s Departmental Business Administrator: Phone #: O I T A Z I R

O Key Issued by: Issue Date: Key #: H T U A ) d

e Received by: Date: r i u q e r s e r u t a n g i s (