Building Representative Form

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 channel of communication
between representatives of University Facilities and Grounds, Office of Environmental Health Services, the Department of Public Safety and occupants of the building. The person chosen as a representative should be willing to accept these responsibilities and be diligent in monitoring the processes involved.

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Building Name *

Name *

Box Number *

Phone Number *

Email Address *

MyBama Username *

CWID *

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

Department *

Building Name *

Name of the Person You are Replacing *

Name of Approving Dean *

Check One *

• Primary Representative
• Alternate Representative

Is this your first appointment as a Building Representative *

• Yes
• No

Submit

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