CITY OF WORCESTER
OFFICE OF THE PARKING ADMINISTRATION
Room 203, City Hall
Worcester, Massachusetts 01608
Residential Parking Permit Application
Please PRINT
Last Name: First Name: M I:
Phone Number: Cell Phone:
Street Address Apartment:
City, State, Zip Code
Check here if you want the permit(s)
mailed to this address.
MAIL ADDRESS if different from resident address above:
Street Address:
Apartment:
City, State, Zip Code
Please PRINT and fill in Registration information below for each Vehicle Sticker Permit you are purchasing.
Registered Owners Name Plate # Vehicle Make Amount
$
$
$
$
$
Total Vehicle Permits $10.00 each $
Total Visitor Pass $5.00 $
Total Amount Due
$
Visitor Pass (one per household)
Yes I want a Visitor Pass
No I do not want a Visitor Pass
Return the completed application, proof of residency, copy of vehicle registration and required fees to the above
address, by June 15th.
I certify that all the above information is correct.
Signature:__________________________________________________________ Date:______________________
click to sign
signature
click to edit
![]()
