Identification Badge Request Form

Indicates required field

Administrator Name

Department

Administrator Email

Administrator Phone

Applicant NET ID

Tell Us About Your Badge Project

Number of People (approximately)

Is Badge Artwork Needed?

There is a one-time setup fee for artwork.

Are New Photos Needed?

Badge Project Deadline

Select Method of Payment

Entity

Fund

Activity

Account

Function

Program

Project

Flex 1

Flex 2

Select Method of Delivery

Map to our location at the Highlander Service Station.

Mailing Address

First

Last

Mailing Address Line 1

Mailing Address Line 2

City

State

Zip Code

Campus Address

First

Last

Building

Room

R'Card Required

Policy now requires the employee/student to have an R'Card before a badge can be provided. If the Employee does not have an R'Card, will the department be covering that expense?

Card Services

Identification Badge Request Form

UCR Card Services