Request for Broken Caltech ID Card Replacement

Instructions

You may request a replacement for your broken ID card by filling out this form, or by visiting the Card Office located in the bookstore between the hours of 9:00am and 1:00pm. You may elect to have your card sent to you via campus mail, provided that you return your broken card. If you would like to update the photo on your ID card, you must appear at the Card Office in person or send a jpeg file (approximately 330 x 400 pixels, 15-20kb) to cardoffice@caltech.edu. Replacements for broken cards costs $5 provided you surrender the broken card within 14 days of receiving the new card. If the broken card cannot be surrendered for any reason, it will be considered lost and the lost ID replacement fee of $15 will apply.

*NOTE: Submitting this form using browsers other than Internet Explorer (i.e. Mozilla, Safari) will cause the submission to fail, even though the "Submitted" screen will appear properly. To avoid difficulties, please use Internet Explorer to submit the form.

Requestor Information

Last Name:

First Name:

 UID:

Status:

Campus Extension:

Mail Code:

   

Email:

   

 

Payment Information

Instructions for payment:

The current broken card fee is $5. If you are a student, faculty member, or post-doc with a personal account, you may choose to have your lost card fee charged against that account. Cardholders without personal accounts may choose to have their lost card fees deducted from their SmartCash accounts. If you would like to do this, but are not sure whether you have sufficient funds in your SmartCash account, please visit our Online Depositing site and deposit the appropriate amount. If you elect to pay by cash or check, you may send your payment, accompanied by a deposit slip to Card Services at MC 1-51. Your card will be sent to you upon receipt of payment. NOTE: Requests will NOT be processed unless a payment method is selected.

PTA to be Charged:

    Project Task

                  Award

 If you are not sure of your exact PTA or Alias, please visit the PTA Alias Query. You will be notified via email if the PTA you provided is invalid.

Endorsement: I hereby certify that I am authorized to make charges against the PTA I provided above.

Photo Option

 

Agreement

I hereby agree to the terms and conditions set forth by Caltech Card Services. I agree to surrender my broken card upon receipt of the replacement. I understand that I will be assessed a lost card fee if I fail to return the broken card within 14 days of receiving my new card.

I agree

Card Retrieval

Comments/Special Instructions:

 

*NOTE: Submitting this form using browsers other than Internet Explorer (i.e. Mozilla, Safari) will cause the submission to fail, even though the "Submitted" screen will appear properly. To avoid difficulties, please use Internet Explorer to submit the form.