Carpool Member Registration Form

Carpool Contract Holder:
 Department:
Contract Facility:
 Permit Number:
Campus Address:
 Campus Phone:
-
Home Address:
Street Address/City/State/Zip
First Carpooler:
 Department:
Campus Address:
 Campus Phone:
-
Home Address:
Street Address/City/State/Zip
Second Carpooler:
 Department:
Campus Address:
 Campus Phone:
-
Home Address:
Street Address/City/State/Zip
Your E-mail:
 

Contract Carpool Conditions:

  • Riders in a carpool must be registered by the contract holder annually prior to June 30.
  • To form a carpool, a person must have two or more people driving to campus together from the same geographical area a minimum of three times per week.
  • Carpool riders can only belong to one carpool.
  • All carpool contract holders must be University of Minnesota employees.
  • Parking contracts are not transferable.
Signature:
 Date:

Form Instructions
To use this form, fill in the appropriate information then either use the submit button to send it to the correct people or choose PRINT from the FILE menu and return to Parking & Transportation Services at

300 Transportation and Safety Building
511 Washington Avenue S.E.
Minneapolis, MN 55455

Or fax to 612-624-8899
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The University of Minnesota is an equal opportunity educator and employer.

Send comments on this web site to U of M Parking & Transportation Services
This page was last modified on 5/24/2004.