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Parking & Transportation Services
340 Bonair Siding, Stanford, CA 94305-7255
T. 650.723.9362 F. 650.724.8676
transportation.stanford.edu
$100, $75, $50, or $25
2014-15 Permit-Return Application
I want to participate in the2014-15 Permit-Return Promotion! I plan to use the following commute mode(s) for
the duration of my commitment (indicate primary mode with “1” and use “X” for any additional modes):
______Train
______Bike
______Walk
______Bus
______Vanpool
______Carpool
______Other ______________________________
My permit-return commitment is indicated below:
Check
One
Deadline to return
your permit
(before 5 p.m.)
Incentive
Duration of commitment
amount
$100 5 months (Nov. through March)
Oct. 31
$100 5 months (Dec. through April)
Nov. 26
$75 4 months (Nov. through Feb.)
Oct. 31
$75 4 months (Dec. through March)
Nov. 26
$50 3 months (Nov. through Jan.)
Oct. 31
$50 3 months (Dec. through Feb.
Nov. 26
$25 2 months (Nov. and Dec.)
Oct. 31
$25 2 months (Dec. and Jan.)
Nov. 26
Type of “A,” “C,” “Z,” or
motorcycle
permits accepted
Annual
and Academic Year
permits only
Program restrictions:
 Must return your Stanford annual (expiring in August 2015) or academic year (expiring in June 2015) permit.
Short-term, residential, carpool, and vanpool permits are not eligible for this promotion.
 Eligible long-term permits must have been purchased on or before Oct. 29, 2014, to be eligible for this
promotion. Contact us at commuteclub@stanford.edu about eligibility if you are new to Stanford and recently
purchased a long-term permit.
 Must join the Commute Club* (Clean Air Cash or Carpool Credit) by published deadline to participate.
 Must not purchase or utilize a parking permit (other than daily scratchers, carpool permit, or vanpool permit)
during the commitment period.
 Exchanging an “A” or “C” for a “Z” permit does not qualify for this promotion.
 Must be an eligible commuter, required to be on campus at least 20 hours a week during normal weekday
business hours, through the commitment period.
 Participants in previous permit-return or permit non-renewal promotions who received a reward within the
last four years are ineligible.
 Individuals who have been enrolled in the Commute Club within three months prior to returning their permit
are ineligible for this promotion.
 The permit-return bonus is paid only after you complete all or an eligible part of the commitment period.
 If you repurchase a permit (other than daily, carpool, or vanpool permits) before your commitment ends, you
may forfeit all or a portion of your Clean Air Cash, Carpool Credit, and Permit-Return Promotion reward.
*Commute Club eligibility. You are eligible for the Commute Club if you meet all of the criteria on the Commute
Club application and the P&TS website: http://commuteclub.stanford.edu. Final eligibility is determined at the
discretion of P&TS. Please send an email to commuteclub@stanford.edu for assistance.
Page 1 of 2 I agree to the above program restrictions. I understand that if I intentionally give false information to
obtain membership in the Commute Club or to participate in this promotion, I may lose my privilege
to receive any transportation benefits from Stanford University, and I may receive disciplinary action
up to and including termination of employment or expulsion.
Printed name: ________________________________________________
Stanford/Hospital ID:______________________
Email and/or phone: ______________________________________________________________________________________
Signature: ____________________________________________________
Date: __________________________________
Submit this form when you return your permit at P&TS, 340 Bonair Siding, Monday through Friday, 7:30 a.m. to 5
p.m., except holidays. You may also submit it via fax (650.724.8676) or email (commuteclub@stanford.edu). Don’t
forget to enroll in the Commute Club, too!
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