Roaden University Center, Room 122
1000 N. Dixie Ave., Cookeville, TN 38505
931-372-6428
parking@tntech.edu
VISITOR PARKING PERMIT REQUEST FORM
A separate form must be completed for each permit being requested.
REQUESTOR INFORMATION
Name: __________________________________________________________________________________________
Title: ________________________________________ Department: _______________________________________
VISITOR INFORMATION
Name: __________________________________________________________________________________________
For large events, separate forms for each visitor are not required. Please put the total number of visitors in lieu of name.
Organization: _________________________________ Contact Number: ________________________________
Reason for Visit: __________________________________________________________________________________
Special Accommodation Request (if applicable):
__________________________________________________________________________________________________
PERMIT DATE INFORMATION
Effective Date: _____________________________ Expiration Date: ____________________________________
____________________________________________________ ______________________
Requestor Signature Date
____________________________________________________ ______________________
Administrative Signature Date
(Only required for special accommodation requests.)
➢ The permit issued will allow for parking in visitor spaces or purple zones only.
➢ These permits may not be given to anyone who is classified as faculty, staff, or student.
➢ Email completed forms to parking@tntech.edu. Please allow up to 3 business days for your
permit request to be reviewed and approved by our office.
FOR PARKING & TRANSPORTATION SERVICES OFFICE USE ONLY:
❑ Form received and permit issued
❑ GV Exemption Approved
❑ CR Approved
Permit Number Issued: __________________________________
Issued by: ___________________________________________
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