January 13, 2022 Access to the University of Rhode Island's W. Alton Jones Campus Please complete this form to request access to the University of Rhode Island's W. Alton Jones Campus in West Greenwich, Rhode Island. RequestorName, Title, and contact information for the person requesting access.Name* First Last Title* URI Employee ID (if applicable) Email* Enter Email Confirm Email Phone*Duration of Requested Access*How long will you need access to the campus?One Semester or LessGreater than One SemesterJustification for Long Term AccessUniversity Status*Please select your status with the University.FacultyStaffUniversity Affiliate (with University Employee ID)OtherIf Other, please explain:*Has the University Space Allocation Committee (SAC) reviewed your request and approved your use of the W. Alton Jones Campus?*YesNoPlease attach a copy of your allocation approval letter from the University's Office of Space Allocation and Analysis (OSAA).*Max. file size: 10 MB.Have your planned research or instructional activities been reviewed by the University Risk Control and Insurance office?*YesNoHave you completed the necessary Facilities Use or Access Agreement with the University's Office of Planning and Real Estate Development?*YesNoPlease attach a copy of your executed Facilities Use or Access Agreement.*Max. file size: 10 MB.Swipe Access for Security Gate*Do you or members of your group require swipe access at the security gate? The gate can also be opened remotely by using the call button to contact Public Safety. Swipe access should be limited to those accessing the site frequently for research or instructional needs.YesNoName and URI Employee/Student ID*Please attach a list that includes the last name, first name, and University employee/student ID for anyone requiring swipe access at the gate.Max. file size: 10 MB.Justification for Short Term AccessUniversity Status*Please select your status with the University.FacultyStaffUniversity Affiliate (with University Employee ID)OtherIf Other, please explain:*Have you completed the necessary Facilities Use or Access Agreement with the University's Office of Planning and Real Estate Development?*YesNoPlease attach a copy of your executed Facilities Use or Access Agreement.*Max. file size: 10 MB.Requested Start Date for Short Term Access* MM slash DD slash YYYY Requested End Date for Short Term Access* MM slash DD slash YYYY Number of Attendees*Activity/Event Description*Please provide details such as the general area of campus to be used, start and end time, access to facilities, or any additional details that will be beneficial to our review process.Have your planned research or instructional activities been reviewed by the University Risk Control and Insurance office?*YesNoOffice of Space Allocation and Analysis (OSAA)Please contact Jeff Ulricksen (401-874-4282 or julricksen@uri.edu), Manager of Space Allocation and Analysis, for assistance with submitting a space request for review by SAC.Planning and Real Estate Development (PRED)Please contact Dulcie Ilgenfritz (401-874-9463 or dilgenfritz@uri.edu), Coordinator for Planning and Real Estate Development, for assistance with completing a Facilities Use Agreement.Risk Control and InsurancePlease contact Pamela Hallagan (401-874-2591 or phallagan@uri.edu), Manager for Risk Control and Insurance, to review your planned research or instructional activities for insurance compliance. Δ