Personal Premium
Parking Permit Application
2019/20
New
Renewal
Name: _______________________________ email: __________________________
Surname Full or Given Name
Department: _______________________________________ Phone ext: ___________
Current Lot: ______ Choice of Parking Locations: 1
st
_____ 2
nd
_____ 3
rd
______
Lot # Lot # Lot # Lot #
License Plate #’s; ____________; ____________; ______________; _______________
Method of Payment: Only applications completed will be considered
Cheque attached – Made payable to the University of Guelph
Payroll Deduction – Sign authorization on second page
Visa/MasterCard or Debit - Transaction at Sustainable Transportation & Parking Services
Office
Charges will not be processed until an agreed choice of parking location has been
determined and the permit issued. Acceptance and use of a parking permit acknowledges
compliance with the terms and conditions of the University of Guelph Parking and Traffic
Regulations.
Applicant’s Signature: ____________________________ Date: ________________
click to sign
signature
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Premium Parking
Payroll Deduction Authorization
(Regular Full-Time Employee Only)
I hereby authorize the University of Guelph to deduct $1462.34 ($1294.11 + 168.23
HST) from my salary, in equal installments; commencing with the second pay in
____________ until April 2020 in the amount of _________________ per month.
Date: _______________________ Signed: ___________________________________
Employee Number: ________________________
TO BE COMPLETED BY SUSTAINABLE TRANSPORTATION & PARKING SERVICES
Premium #: P ____________ __ Lot Assigned____________ _ Zone ____________
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signature
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