Link to: The University of Western Ontario Link to: Western Parking and Visitor Services




Retiree Permit Application Form



Statement of Agreement
Do you accept the Statement of Agreement as the terms and conditions of this parking permit?

* I Accept
        I DO NOT Accept (you will be redirected back to the parking homepage)


References
Rate Schedule, Permit Information, and Campus Parking Map



Mandatory information is indicated by a *

Your Status is: *

Retiree

Do you require Disabled Parking?

Ministry of Transportation Disability Permit Number:
Expiry Date:


Account Information
Please enter the following data to update/setup your parking account.

Your email address *:
Surname/Company Name *:
Firstname/Company Name *:
Initial:
Student/Employee Number :


Local Address Information
Local/Campus Address:
City/Building:
Province/State:
Postal Code:
Phone Number:


Home Address Information
Home Address*:
City *:
Province/State:*:
Postal Code *:
Phone Number *:



Vehicle Information

Vehicle 1* Vehicle 2 Vehicle 3
License Plate*: License Plate: License Plate:
Province/State*: Province/State: Province/State:
Vehicle Make: Vehicle Make: Vehicle Make:
Vehicle Model: Vehicle Model: Vehicle Model:
Vehicle Colour: Vehicle Colour: Vehicle Colour:
Vehicle Type: Vehicle Type: Vehicle Type:



Transponder Information

A $30.00 refundable deposit applies to the transponder purchase. Please choose *:

Yes, I need a Transponder

No, I already have a Transponder



Do you need a Motorcycle Permit?

Motorcycle Permit Required

Motorcycle Permit Not Required



New Retiree Permits

Your application will be processed and you will receive an email when your permit is ready for pick up. Your transponder deposit of $30 may be made by the following payment methods: Cash, Cheque, Debit Card, Visa, Mastercard and American Express. Pick up new permits at our main office in Room 4150, Support Services Building.

Remember to bring photo identification, vehicle ownership and official Western notice of retirement with you to obtain your new permit.

Retiree Permit renewal stickers for current Retiree Permit holders will be mailed out to your Priority One Address.

All Retiree Permits will automatically expire on August 31st. You will need to renew your permit online in August of each year. Thank you!



     

Online Payments are secured by:

Western Parking and Visitor Services is proud to be a member of the:
Ontario Campus Parking Assoc., Canadian Parking Assoc., International Parking Institute

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