Name: ________________________________________________________________
College Park Address: ______________________________________________________
Phone No. ________________________________________________________________
Email address (optional): ______________________________________________________
Would you prefer to be contacted by phone or email? _______________________________
What district do you live in: District 1 District 2 District 3 District 4
I understand that the University of Maryland Shuttle System is operated by the University of Maryland and
not the City of College Park. In consideration of being given a University of Maryland Shuttle System
ridership pass by the City of College Park, I hereby waive and release the City of College Park and its
officials, employees and agents from and against any and all claims for damages to person or property that I
may have in the future arising from my ridership on a University of Maryland Shuttle vehicle.
________________________________ _____________________
Signature Date
This application must be presented with proof of City residency at City Hall, 4500 Knox Road, College Park,
MD 20740. Applications received by mail will not be accepted.
Office Use Only: (Applicant should not write below this line.)
Control No.: ______________
Proof of residency type: _________________________________________________
Date issued: ___________________________________ Initials: ____________
City of College Park
Shuttle UM Bus Pass Application