ID Badge Request Form

Fill out the fields below. A PolyCard staff member will contact the requestor to schedule a pickup date. Please allow two (2) business days for processing.

Requestor
Recipient
Cal Poly username or email address
General Cal Poly Badge Options
ANTS Badge Options
Example: Student Assistant
Police Badge Options
Select from the list and type in Police Title below. 
MM/DD/YYYY
Emergency Management Card Options
DEM000001
MM/DD/YYYY
Facilities Customer & Business Services Options
Please enter Job Title below.
Facilities Energy, Utilities & Sustainability Options
Please enter Job Title below.
Facilities Environmental Health & Safety Options
Please enter Job Title below.
Facilities Management & Development Options
Please enter Job Title below.
Facilities Operations Options
Enter a shop or work area
Facilities Planning Options
Please enter Job Title below.
The file must include:
- First Name
- Last Name
- Calpoly username or email address
- Badge or card to be printed
- Shop and/or Job Title required by the badge/card

Files must be less than 800 KB.
Allowed file types: gif jpg jpeg png txt rtf doc docx xls xlsx.
Do you wish to have an oval hole punched and/or receive a clear ID badge clip?
Please describe any additional requirements

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