Montana State University-Great Falls College of Technology
I.D. CARD AUTHORIZATION FORM

(To be completed by AUTHORIZED OFFICIAL within the COT)

Name:   ________________________________________________________________________________

Department:   ___________________________________________________________________________

Payroll I.D. # or Social Security Number: ____________________________________________________

Position (Staff, Faculty, Adjunct Faculty): ____________________________________________________

Card Expiration Date (Adjunct Faculty only): _________________________________________________

_______________________________________________________        ____________________________
Employee Signature                                                                                     Date

_______________________________________________________         ____________________________
Department Head                                                                                          Date

_______________________________________________________         ____________________________
Dean or Authorized Designee                                                                       Date

Present this form to the Assistant Registrar