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Mardi-Gras-Season-Parking-Pass-Application1

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MARDI GRAS SEASON PARKING PASS APPLICATION FOR NICHOLLS STATE UNIVERSITY
This application must be submitted to University Police in Calecas Hall (corner of Ardoyne and Acadia). Spaces are sold on a first come-first serve basis and are not reserved until an application and the full amount is paid. Applications should be hand-delivered, but you can mail your application and payment to:
Nicholls State University Police Department
P.O. Box 2784
Thibodaux, La., 70310
We accept only checks or money orders made out to Nicholls State University.
Name: Home Telephone: __
Address: _______
E-Mail Address: Cell Phone: ______________________
Parking Permit & Vehicle Information Request
1st Camper - 2015 Season Charge: $200 $
License Plate:_____________ Make/Model:__________
2nd Camper - 2015 Season Charge: $200 $
License Plate:_____________ Make/Model:__________
1st Vehicle (truck, van, car) - 2015 Season Charge: $50 $
License Plate:_____________ Make/Model:__________
2nd Vehicle (truck, van, car) - 2015 Season Charge: $50 $
License Plate:_____________ Make/Model:__________
2015 TOTAL ENCLOSED$
FOR UNIVERSITY USE ONLY
Date Received: Time Reviewed: By Whom:
Assigned Camper Space:Permit #:
Assigned Camper Space:Permit #:
Assigned Auto Space:Permit #:
Assigned Auto Space:Permit #:
Mailed Permit with Assignment Information-Date:
Rejected Application due to lack of space or unpaid debt to the University- Date:
***VEHICLE OWNERS AND CAMPERS WHO WANT TO BE PARKED SIDE-BY-SIDE SHOULD GO TO UNIVERSITY POLICE TOGETHER TO MAKE RESERVATIONS OR INCLUDE BOTH RESERVATION REQUESTS WITH PAYMENTS IN A SINGLE MAILED ENVELOPE.
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