C&PS: TDMP Book Permit Form

Cornell University: Transportation and Mail Services: Commuter and Parking Services

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EMPLOYEE BOOK PERMIT ORDER FORM

This form is for employees participating in the
RideShare, OmniRide, Occasional Parker programs and the FamilyCare support service.

Please use this form only if you are eligible for no-fee, one-day book permits. FamilyCare books require a separate application annually. To request an application, contact C&PS. Your book permit request will be mailed to your campus address. Please allow at least one week for processing and delivery.

Information About You:
Name:
Phone:
Cornell Net ID:		Employee ID#:
Campus Mailing Address:
TDM Program :
How do you use your one-day parking permits?
Please help us serve you better by answering these questions about one-day permit usage. Your response will help us in developing future Transportation Demand Management programs and incentives.
Average number of permits used in a one-month period:
In what permit area do you usually park with your one-day permit:
What is your primary reason for using one-day permits?
Order Commuter Books of One-Day Parking Permits
Please indicate the number of book permits you are requesting. You will only receive the number of no-fee books for which you are currently eligible. Please be sure complete the vehicle information section if you have any vehicle changes or additions.
Number of Books :
Your Vehicle Information
Book permits must display a Transportation Services label with the correct license plate information for the vehicle on which it is used. If you have not changed license plates or added vehicles since you last ordered book permits, we can use the information you have on file. If you have vehicle changes or additions, please make them below. Please note the type of change you are making. There is also a section where you can remove a vehicle, if necessary. We may contact you to clarify or verify your changes. If you need help, give us a call at 255-4600 or send us an email.
My vehicle info:
Information about your first vehicle change/addition:
This is a: Plate change Vehicle change Plate and Vehicle change/addition
State/Province:	Plate (required):
Vehicle's year:	Vehicle's make:
Vehicle's body style:	Vehicle's color:
Registered owner's name:
Owner Relationship :
Information about your second vehicle change/addition:
This is a: Plate change Vehicle change Plate and Vehicle change/addition
State/Province:	Plate (required):
Vehicle's year:	Vehicle's make:
Vehicle's body style:	Vehicle's color:
Registered owner's name:
Owner Relationship :
Information of the vehicle (if any) to be removed:
State/Province:	Plate:
Vehicle's year:	Vehicle's make:
Vehicle's body style:	Vehicle's color:
Registered owner's name:
Owner Relationship :
Contract: As a member of the Cornell University community, I agree to pay the published price for the pass offered to me by Transportation Services. I will comply fully with any sanctions specified by the university, should any violations occur. Should I not comply with university sanctions, or fail to comply with these terms, the university reserves the right to revoke the pass. I understand that parking restrictions or transit service may be temporarily suspended or changed due to holidays, weather conditions, special events, campus construction, or emergencies.
Agree We will process your request; you will receive your books of permits, if requested, by mail in about a week.

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