Building Representative Update Form

Please complete this form and click the “Submit” button below. For questions contact Marcie Porter at mporter1@ua.edu or 205-348-8703. Please allow three to five business days for these changes to take effect.

The primary responsibility of the building representative is to serve as the communication channel between the representatives of University Facilities and Grounds, Office of Environmental Health Services, the Department of Public Safety, and building occupants. The person chosen as a representative should be willing to accept these responsibilities and monitor the processes diligently.

Building Name *

First Name *

Last Name

Box Number *

Phone *

Email Address *

MyBama Username *

CWID *

Division (Finance and Operations, Student Life, etc.) *

Department *

Name of the Person You are Replacing *

Name of Approving VP or Dean *

Text

Check One *Primary RepresentativeAlternate Representative

Is this your first appointment as a Building Representative?YesNo

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