QCRA Access Request - the Zone
To ensure smooth access to our facilities, please download the Vizpin Smart app on the phone will be used to open doors. Create an account in the app and request access using Location ID: CTN-4NX. Completing these steps prior to submitting the access request will help speed up the process.
Sign in to Google to save your progress. Learn more
Email *
STOP - Important Reminder
Before you complete and submit the form, ensure the individual has created a user ID via their Vizpin Smart app. We cannot proceed until the account is created in the system.
First Name (Requestor)
 *
Last Name (Requestor)
 *
First Name (Request for) *
Last Name (Request for) *
Email (Request for if not the same as the requestor) 
Phone number *
The phone number associate with the phone will be used to unlock the door.
Consent Completed *
All users are required to consent (link to the consent form) before being approved to access the building. 
Required
Age of the person requiring access *
If the person requiring access 18 years or older at the time of the application. 
Required
Affiliation
 *
Contact kaiwencheng@queencityrobotics.org to have your team added if it is not in the dropdown list before you complete the request.
Provide details if you choose "Other"
Whom do you request for?
 *
If you are affiliated with a team but not the lead mentor.  Please have your team lead mentor request for you. 
Required
Reason for Access *
Note
Contact Kaiwen Cheng, Elvis Lopez, or Robbie Hoyler if your request do not get processed within 5 business days or you want to provide additional information.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Queen City Robotics Alliance.

Does this form look suspicious? Report

Google Forms