Biometric Security Device Request Form
Complete this form to request access to a biometric security device. All information provided will be used solely for processing your request.
Requester Name
*
First Name
Last Name
Department/Team
*
Work Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Device Type Requested
*
Please Select
Fingerprint Scanner
Iris Scanner
Facial Recognition Terminal
Other
Intended Use/Purpose
*
Access Location/Site
*
Preferred Access Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason/Justification for Request
*
Manager/Supervisor Approval Contact
*
Submit Request
Should be Empty: