BAS03 APPLICATION FOR THE REGISTRATION OF THIRD PARTY

BAS03 APPLICATION FOR THE REGISTRATION OF THIRD PARTY




BAS03 - Application for the Issue of a Third-Party Identification and Access Control Card

BAS03 APPLICATION FOR THE REGISTRATION OF THIRD PARTY

BAS03 - Application for the registration of Third Party identification and associated access to UCT resources

Please note:

Purpose: Use this form when you want to register a new third party and apply for access to UCT resources.

All third parties will be issued with a unique third party number to be used for their access card, network and/or e-mail account access, if applicable.

Send this form to your departmental administrator/Third Party System user, or to Access Control:
Note: Access Control will only renew or edit third parties on presentation of a completed BAS06 form and in an emergency.

Properties and Services Maintenance Building, Room no.2.01, Upper Campus, Rondebosch

Phone:

(021) 650 1199

Dates of access requested* Note: Enter start and end dates.

( * = Required section)

Access start date


Access end date



Sponsoring UCT department/ organisational unit details

( * = Required Fields)

Department/Organisational Unit name*


Organisational Unit code


E-mail address*


Personal details

First name*


Surname*


Initials*


Preferred name


Title (i.e. Prof/Dr/Mr/Mrs/Miss/Ms):


ID type (ID Document/ Passport)*


Issuing authority (RSA Government, U.K, USA)*


ID No.*


Telephone no.


Cell phone no.


Postal / Physical address *


E-mail address



Fax no.



Postal code


If you have ever been a UCT employee, please enter your staff number


Representing… (details of affiliation e.g. company details)

Affiliation/employer name *


Cell phone no.


Postal / Physical address *


Telephone no.



Postal code





Access required to…

( * = Required Fields)

Note: Values are driven by the UCT Role Model, and may override your selections here. See: UCT Role Model for third parties

Physical access *

Yes

No

Building / door


Network *

Yes

No

E-mail

Yes

No

Internet

Yes

No

Library *

Yes

No


Online learning *

Yes

No

Online learning type

Student

Staff

Parking *

Yes

No

Parking area


Parking type (Student/Yellow/Red)



Role and reason for visit

( * = Required Fields)

Role *

(tick one)

Contract staff/ Consultant

Library subscriber

Visiting academic

Visiting student

Residence guest

Member of council

Conference attendee

Short course attendee

Family of UCT staff living in UCT accommodation

Other (please specify)


Reason for visit *




Please note:

The details of the sponsoring department will be printed on the access card. Examples are:

  • PGWC-GSH: for PGWC staff on the GSH establishment who work at UCT and need a UCT identification/access control card.

  • Visitor: for a person who is a visitor to a department/faculty who is not paid by UCT as a visiting staff member during this period.

Building access is controlled independently. The HOD or Building Curator will independently request that a named holder of a UCT Third Party identification card be granted controlled access to specific buildings or rooms, if appropriate and necessary.

Third Party Card applicant agreement

( * = Required Fields)

“I hereby acknowledge that the card to be issued to me will remain the property of UCT and that I am responsible for returning it to UCT on expiry of my period of affiliation.”

Signature of Third Party card applicant *


Date *


UCT Sponsoring department approval

( * = Required Fields)

Name of HOD/Dean/Director *


Signature of HOD/ Dean/Director *


Date *



FOR OFFICE USE ONLY (to be completed by the Issuing Officer, Access Control Services):

Card Issue approved

Yes

No

Signature


Date


Card Issued

Yes

No

Signature


Date



Conditions governing the issuing of third party identification and access control cards and visitor cards


1. THIRD-PARTY IDENTIFICATION AND ACCESS CONTROL


All third parties working at UCT permanently or temporarily (if for periods of 2 weeks or more), and if supported by one of the following: the head of department (academic departments); the director / head of department (administrative and support departments); must be issued with THIRD PARTY IDENTIFICATION and ACCESS CONTROL CARDS.


These cards serve three distinct purposes:

  1. identification,

  2. where authorised, access to an access-controlled building, and

  3. where authorised, library borrowing-privileges and access.


Examples of third parties would be:


Please note:


2. VISITORS CARDS



Queries to be directed to our Access Control Services offices at any time during normal office hours.

Our contact number is: (021) 650 1199


These steps are towards a safer studying, working and living environment.

24 March 2015 Page 3 of 3 BAS03





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