First Name
Last Name
Email
Phone
Department
Type
Department/Organization
Access Request
Please provide the following information for the person who needs access.
Access Request Type
First Name
Middle Initial
Last Name
EID/SID
This is the number on the front of your Cal1Card.
Card Number
The first 6 digits of the number on the back of the Cal1Card.
You may select up to 4 Access Groups below.
Please click
here
for more information on each of the Access Levels we have available for keycard access.
Access Group 1
Access Group 2
Access Group 3
Access Group 4
Maintenance Request
If this is a fire or life safety emergency please call UCPD at (510) 642-3333.
If this is an issue in need of immediate attention from our team please call (510) 292-7189.
Please upload any available pictures in the File Upload field below.
Operational Support
Support Type
Key and Lock Support
Core Number (if known)
Entry Outside Building Hours
Entry Details
Date of the Incident
Number of People
Please include the reason for your request in the Description field below.
Delivery Notification/Support
Delivery Name
Expected Delivery Date
Type of Delivery
Delivery Support
SUFMO Support
If you selected "other" in any of the above fields, please explain your needs.
Delivery Address
Business Purchased From
Carrier
Examples: USPS, FedEx, UPS, OnTrac
Tracking Number
Please see below for the descriptions of each Type of Incident:
Building/Campus Policy Violation
- Any/all policies set by campus (please click here more information).
Damage to Property
- Physical damage to campus property (i.e. skateboard breaking window, lobby table being carved, breaking ping pong paddles, etc)
Personal Injury
- Injury while occurring on premises
Solicitation
- Asking for or trying to obtain something from someone (panhandling, shoplifting, etc)
Theft
- Property belonging to another individual (i.e. phone, backpack, bottle, etc)
Vandalism
- Damage belonging to campus (i.e. graffiti tag, removal/destruction of signage, etc)
Witness to Injury
- Person(s) who has witnessed an injury to another.
Other
- If other, please specify what type of incident occurred in the description field.
Type of Incident
Please select the type of incident then press the next button.
Building
Room
Subject
Description
File Upload
File Upload
Salesforce Record IDs (All these fields should remain hidden)
Case ID
Contact ID
Record ID
Record ID
Building ID
Room ID
For security purposes, do not include any private information in this form such as credit card, social security numbers, or private health information.
Incident Report
Date
Time
Please indicate AM or PM for the time.
In what building did the incident occur?
Reports occurring on non ASUC or Student Union property must be filed with UCPD or the building it pertains to.
Suite/Room
If the incident occurred in a suite/room please select the room from this list.
What floor did the incident occur on?
Incident Room ID
Please provide any other details of the location where the incident occured.
Details of the Incident
Subject
Example: Upset Student in Lobby
Description of the Incident
Who was involved? If possible, include names, clothing descriptions and/or physical characteristics.
Has this been resolved?
What was the resolution?
UCPD Information
If applicable, please provide the UCPD Case Number or UCPD Event Number.
UCPD Case Number
UCPD Event Number
File Upload
Please upload any related photos or documents.
For security purposes, do not include any private information in this form such as credit card, social security numbers, or private health information.
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