Required fields are marked with asterisks (*)

CITY OF KITCHENER ACCESS DEVICE REQUEST FORM

Note: All employees will be given access to the cafeteria, parking levels and their work floor/work area 24/7

This request if for:

A new employee

A temporary employee

A fulltime employee with a change in role

A transfer of an existing access device to another employee

A replacement for a lost or damaged access device

An extension of device access

Employee name

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