University of California Santa Cruz
Transportation and Parking Services
1156 High St., Santa Cruz, CA 95064

2021 - 2022 Retiree Parking Permit Application
Applicant Information
Last Name
First Name
Middle Initial

Residential Address
City
ZIP

Employment Status
Email
Phone
Permit and Bus Pass Selection
Choose one of the following complimentary options:

Free SCMTD Bus Pass

I would like to receive a Metro (SCMTD) Bus Pass.

 

Free Motorcycle Permit

Free Motorcycle permit. Not valid in metered spaces.

 

Free A Parking Permit

Good for close in parking in A spaces, not including metered spaces.

Disability-Related Parking Needs
 
Select one of the following if applicable:
I have a DMV Placard or plates that I will display with my UCSC Retiree Parking Permit to park in ADA spaces (or other non-reserved spaces) on campus.

I do not have a DMV Placard or plates but need closer parking for medical reasons. 
I am submitting the required authorization from a medical practitioner, the Disability Resource Center, or the Health Center, confirming my need for disability-related parking in Medical spaces. I understand that I will not be allowed to park in ADA spaces.

Delivery Options
Vehicle Information
Enter your license plate number.
If applying for programs only (such as a Metro Bus Pass) enter 123456 in the Vehicle 1 field.
  
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Authorization
I acknowledge that my signature below authorizes UCSC Transportation & Parking Services to issue the items I have selected on this application. It also authorizes a one-time deduction and/or charges to my credit card for these items. My signature indicates I have provided accurate information and that I agree to abide by all campus parking policies, regulations and procedures. I agree to be responsible for the cost of all unexpired items until they are returned for cancellation to the TAPS Sales Office, regardless of use. I acknowledge that TAPS assumes no liability for items lost in the mail. Lost items will be subject to a replacement fee.No refunds will be given if permits are not picked up at the TAPS Sales Office.

Email Notifications

I would like to receive occasional email updates and reminders from TAPS. I understand that by opting out of emails, I may not receive notifications and reminders regarding parking permits..

Signature
Signature Date
Comments and Submission
Comments