Key Card Application

Key Card Application Form
Card #______________ Access: _________________________
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Please state your reason for needing access to the building during times other than regular church/office hours:*
Security Access Card Guidelines

In order to ensure the safety of all church members as well as staff, Tulip Grove is equipped with a card access security system.

Security cards will be issued to member positions only. this would include staff members, main leaders, committee and department chairpersons who might need access at hours other than regular working hours. Cards will be issued to individuals when they have a specific purpose for entering the church facility as noted above.

Please note. . . if you are issued a card and you allow someone else to use your card, you will be held responsible for any problems that may occur during the usage. It is important that doors not be propped open for ANY reason at ANY time.

If you lose your card, please notify the church office immediately so that it can be deactivated and a new card can be issued. There is a $5 charge to replace a lost card. To maintain safety, we reserve the right to revoke any cards if the need arises.

Please use your card wisely and remember we all play a part in protecting God's house and keeping it secure.
I have read and agree to abide by the guidelines set forth. *

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Date*

MonthDayYear
Date
Office Use Only
I approve the above individual for a key or key card to the building.
__________________________________ ___________________
Name Date
Should be Empty:

Key Card Application Form