Temporary Accessible Parking Permit

This form is for a short-term (two week max) parking permit. See the Accessible Parking Request form for longer term options.
Allows customers to request a temporary accessible parking permit for up to two weeks. After approval, you must pay parking fee ($20 a week) to park in ADA spaces. Parking is not guaranteed.
Name(Required)
Email(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Passes are available for a maximum duration of two weeks. Requests longer than that will be denied.
Vehicle List(Required)
License Plate
Make
Model
 
Accepted file types: pdf, Max. file size: 5 MB.
Must be a PDF of a doctor's note or DMV application for permanent/long-term ADA permit.