Facilities Data Security - Page 2 of 3

University student/employee request

Thank you for taking the time to provide this information so we can complete your request.

Instructors should make requests on behalf of their students. The instructor should complete the form and attach a list of the names of the students who require the information.

After review, the requestor will be notified of approval via email by the Emergency Management Department. The email approval will include document pick up information. You will need your University ID card to retrieve the information you are requesting.

Requestor information

Please tell us you you are and how we can contact your or deliver the requested information.

*Your name:

*Your email:

*Phone number:

UIN:

*How are you affiliated with the university?
StudentInstructorOther (please specify below)

What class is this for? (leave blank if it's not for a class)

If you are the class instructor, please list the names of students associated with this project:

Information needed

Tell us what information you need here. Please be as specific as possible. Your college, school or department office may be able to assist with building numbers.

*Name of building or grounds:

*Address or physical location:

Room number(s) (leave blank if not applicable):

*Detailed description of information requested:

*Reason this information is needed:

Attach any files here that further describe the project or the information needed

Faculty approval

The approving sponsor should be a class instructor, department head, dean, or school/college enrollment office.

*Faculty sponsor's name:

*Faculty sponsor's email:

*College:

*Department:

Submittal

Information provided by the University of Illinois is the property of the university and should be used solely for work authorized by and executed on behalf of the university. Reproduction or redistribution of this information beyond the scope of the specified project is prohibited. In providing documents to you, the University does not vouch for the accuracy of scale, content, or layout. The university attempts to provide the best available information, but many plans/maps are based on information which may or may not reflect all renovations or modifications to a building/site or to university or municipal utilities infrastructures serving the campus. Consequently, documents should not be used for design without first being field measured and verified.

By checking this box, I certify that the information to be accessed will be used in compliance with the University's campus policy on Distribution of Building Plan Documents and Architectural Drawings, and that I have read and understand the disclaimer printed above.

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