University ID# or HawkID:
Name (Please Print):
Card Type:
Student (01)
Faculty/Staff (02)
Affiliate (99)
Issue / Replace Reason:
New‐First Card
Damage (*if intenƟonal)
Lost/Stolen*
New Photo*
University ID# or HawkID:
Date:
Name (Please Print):
(* indicates $35 fee will apply)
Card Type:
Name Change
Returning Student
Appearance Change
Other:_____________
Student (01)
If I am replacing a card for one of the reasons indicated above by a *,
I agree to pay the $35 replacement fee which will be charged to my U‐Bill.
Signature:
OFFICE USE ONLY
(circle one) N/C $35
Date:
Issue / Replace Reason:
New‐First Card
Damage (*if intenƟonal)
Lost/Stolen*
New Photo*
Faculty/Staff (02)
Affiliate (99)
Name (Please Print):
Card Type:
Student (01)
Faculty/Staff (02)
Affiliate (99)
Issue / Replace Reason:
New‐First Card
Damage (*if intenƟonal)
Lost/Stolen*
New Photo*
Signature:
OFFICE USE ONLY
(circle one) N/C $35
Processed by:
University ID# or HawkID:
Date:
Name (Please Print):
(* indicates $35 fee will apply)
Card Type:
Name Change
Returning Student
Appearance Change
Other:_____________
Student (01)
If I am replacing a card for one of the reasons indicated above by a *,
I agree to pay the $35 replacement fee which will be charged to my U‐Bill.
Signature:
Name Change
Returning Student
Appearance Change
Other:_____________
If I am replacing a card for one of the reasons indicated above by a *,
I agree to pay the $35 replacement fee which will be charged to my U‐Bill.
Processed by:
University ID# or HawkID:
(* indicates $35 fee will apply)
OFFICE USE ONLY
(circle one) N/C $35
Processed by:
Faculty/Staff (02)
Affiliate (99)
Date:
Issue / Replace Reason:
New‐First Card
Damage (*if intenƟonal)
Lost/Stolen*
New Photo*
(* indicates $35 fee will apply)
Name Change
Returning Student
Appearance Change
Other:_____________
If I am replacing a card for one of the reasons indicated above by a *,
I agree to pay the $35 replacement fee which will be charged to my U‐Bill.
Signature:
OFFICE USE ONLY
(circle one) N/C $35
Processed by: