Registration Form Parking Permit Fee Schedule: Fall only Semester permit- $37.50 Annual permits - $75 Winter only Semester permit - $37.50 Important Note: In order to encourage the prompt purchasing of parking permits the following deadlines have been put in place: For Fall only and Annual permits, applications must be completed and payment made by September 15, 2017. Otherwise, the fee increases to $50 and $100, respectively. For Winter only permits, applications must be completed and payment made by January 12, 2018. Otherwise, the fee increases to $50. For students, please note that no payment is required, the amount owing will be automatically added to your student account. If you are registered or working at Redeemer for both fall and winter semesters, an Annual permit must be purchased in the fall to help reduce the administrative workload. Please refer to the student handbook for more details.First Name*Last Name*Email* Phone (or cell phone)*Relation to Redeemer?*RA/HAOn Campus Student Fall/WinterOn Campus Student Fall Semester OnlyOn Campus Student Winter Semester OnlyOff Campus Student Fall/WinterOff Campus Student Fall Semester OnlyOff Campus Student Winter Semester OnlyStaff/Faculty Fall & Winter Semesters (annual permit)Staff/Faculty Fall Semester Only (fall permit)Staff/Faculty Winter Semester Only (winter permit)Athletic Member (annual permit)Other Other (please describe)*Student ID:*Resident or Dorm No:Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country How many vehicles are you registering?*Select123How many vehicles are you registering?*Select123Parking Permit Price: $ 100.00 CAD Parking Permit Price: $ 50.00 CAD Vehicle #1 Vehicle #1 Vehicle #1 Make*Vehicle #1 Make*Vehicle #1 Model*Vehicle #1 Model*Vehicle #1 Colour*Vehicle #1 Colour*Vehicle #1 License Plate:*Vehicle #1 License Plate:* Vehicle #2 Vehicle #2 Vehicle #2 MakeVehicle #2 MakeVehicle #2 ModelVehicle #2 ModelVehicle #2 Colour:Vehicle #2 Colour:Vehicle #2 License PlateVehicle #2 License Plate Vehicle #3 Vehicle #3 Vehicle #3 MakeVehicle #3 MakeVehicle #3 ModelVehicle #3 ModelVehicle #3 ColourVehicle #3 ColourVehicle #3 License PlateVehicle #3 License PlateWould you like an additional permit for your 2nd vehicle?(This is an optional purchase. This is for your convenience.)Optional1 additional permitWould you like an additional permit for your 2nd vehicle?(This is an optional purchase. This is for your convenience.)Optional1 additional permitWould you like additional permits for your 2nd and 3rd vehicle?This is an optional purchase. This is for your convenience. (For your 3 vehicles you may purchase 1 additional permit or 2)Additional Permit?1 additional permit2 additional permitsWould you like additional permits for your 2nd and 3rd vehicle?This is an optional purchase. This is for your convenience. (For your 3 vehicles you may purchase 1 additional permit or 2)Additional Permit?1 additional permit2 additional permitsTotal $ 0.00 CAD Agreement* I have read and accept the terms and conditions Terms and Conditions NameThis field is for validation purposes and should be left unchanged.