Adjunct and Visiting Faculty Vehicle Registration Form - Parking

Contact Information of Person whom Parking is being requested:

First Name:

Last Name:

UIN:

E-mail:

Phone Number:

Submitters's Name:
(If different from above)

Class you are teaching or reason you will be at the Law Building for which you are requesting parking privileges:

Are you requesting parking privileges for more than 3 days? (Check box if yes):

Date and time during which you need parking? (Please be as specific as possible - i.e. 10:45 am to 11:15 am on Tuesday, July 30.):

Please describe the time period during which you need parking. (Please be specific as possible. - i.e. Tuesdays and Thursdays from 2:15 pm to 4:15 pm during the spring semester.):

Vehicle 1

Vehicle 1 Color:

Vehicle 1 Make:

Vehicle 1 Model:

Vehicle 1 License Plate:

Vehicle 2

Vehicle 2 Color:

Vehicle 2 Make:

Vehicle 2 Model:

Vehicle 2 License Plate: Leave this field blank