Morehouse School of Medicine
Key & Locksmith Services Request Form

PLEASE DO NOT WRITE IN THIS BLOCK
Job Number:

Instructions:

 1. Complete purchase requisition.   Please make all key order requisitions payable to MSM – Locksmith Services Acct. # 1-6-6016-00101-6352.
2. Complete this form. 
3. Print this form
4. Send the signed form with the requisition within 2 days directly to the Access Control Center via interoffice mail.
Please submit this form to The Access Control Center as soon as possible so that your key orders can be processed in a timely manner. Your cooperation will be highly appreciated.

Person requesting service

Dept.   

Ext.  

Requestor’s Signature

Authorized Signature – Department Head  

Account #  

Date of request  

Please check the box next to the job description being requested

Key (s) duplication
 Key extracted
Door lever needs to be replaced

File or Desk key duplication
Replace door cylinder
Other


THIS BLOCK IS FOR MEDECO KEY ORDERS (ONLY)
Bldg/Room # Keyway No:Key No: No. of Key’s requested:
Bldg/Room # Keyway No: Key No: No. of Key’s requested:
Bldg/Room # Keyway No: Key No: No. of Key’s requested:
Bldg/Room # Keyway No: Key No: No. of Key’s requested:
Bldg/Room # Keyway No: Key No: No. of Key’s requested:
Bldg/Room # Keyway No: Key No: No. of Key’s requested:
All Medeco Keys cost $13.50 ea
SYSTEM NUMBER M1715


THIS BLOCK IS FOR MULTI – LOCK ORDERS (ONLY)
Building/Room #   Key No:   No. of Key’s requested:
Building/Room #   Key No:   No. of Key’s requested:
Building/Room #   Key No:   No. of Key’s requested:
Building/Room #   Key No:   No. of Key’s requested:
Building/Room #   Key No:   No. of Key’s requested:
Building/Room #   Key No:   No. of Key’s requested:
All Multi – Lock Keys cost $10.50 ea


Please make all key order requisitions payable to MSM – Locksmith Services Acct. # 16601600101-6352.