Disability Parking Request Form

Please complete the following request for a Disability Parking Permit. A completed Physicians Authorization Form or Saskatchewan Abilities issued Placard is required to complete the Disability Parking Permit application. By submitting this form you are agreeing to the terms and conditions of the Parking and Transportation Services agreement and acknowledging that the information provided below is accurate and correct.

Name :
Employee or Student ID #:
Do you currently have a SK Abilities Placard: Yes
No
SK Abilities Placard #:
Address:
Primary Phone Number:
Email Address:
Vehicle Make :
License Plate Number:
Province :
Do you currently have a parking stall on campus?: Yes
No
If yes, provide current location:
Do you require evening parking?: Yes
No
Which building(s) do you require access to?:
Disability and Limitations (Please be specific) :
Please attach a completed Physicians Authorization Form :