Parking and Transportation Services
61 Lomb Memorial Drive
Grace Watson Hall
585-475-2074
Fax 585-475-7510
COMMUNITY/TEMPORARY PASS APPLICATION
1.
CUSTOMER INFORMATION
Please print clearly. All information must be complete and legible. Incomplete forms will not be processed. A LOCAL
ADDRESS MUST BE PROVIDED.
Name:
Last
First
Middle Initial
State
Zip
Address:
City
2.
Cell Phone #:
Home #:
UID:
Email:
PERMIT TYPE Payment is based on permit type (if applicable)
Please Select One:
Alumni
Gym Member
OSHER Institute
Other ____________________________________________
Retiree
Rivers Run
Temporary Permit (1-3 Month Assignment)
__________________________
All Faculty, Staff and Students should utilize the online Parking system to order permits. No Forms will be accepted-
NO Exceptions.
3.
VEHICLE DESCRIPTION All vehicle information is required.
A valid Vehicle Registration Card is required when registering a vehicle.
State:
License Plate #:
Model:
Color:
Vehicle Year
Type:
(2dr, 4dr, Wgn, SUV, Trk, Van)
Motorcycle)
Rental Vehicle
Make
Owner
Driver
Temporary Vehicle
Rental Agreement
FOR OFFICE USE ONLY
ID Verification:
Vehicle Registration
Permit Issued By:
RIT ID
No
Date
Other _________
Yes
Mailed
Notes: _______________________________________
Alumni
Retiree
Gym Member
Rivers Run
OSHER Institute
Visitor
Temporary Employee T ____________ Exp. Date ______
Other ___________________________________________
Permit Number
Verified _________________________________________