SciTech Campus Special Event Request Form
Event Name
*
Event Date
*
-
Month
-
Day
Year
Date
Start Time
*
AM
PM
AM/PM Option
End Time
*
AM
PM
AM/PM Option
Number of Attendees
General Permit Area Enforcement Exemption Request
General Areas Enforcement Exemption
# of Days Requested
Subtotal
Less Than 125 Attendees
Monday-Friday ($425)
Saturday/Sunday ($125)
125 or More Attendees
Monday-Friday ($600)
Saturday/Sunday ($125)
Total
Daily & Weekly Permits
General Permit Areas
Quantity
Subtotal
Daily Permit ($8.50)
Weekly Permit ($35)
Total
Reserved Parking Space Request
Reserved Parking Space
# of Spaces
Subtotal
General Permit Space ($25)
Total
Parking Signs and Sign Holders
Parking Signs
Quantity
Subtotal
Black & White ($10 each)
Color ($20 each)
Total
Verbiage
Sign Holder Rentals
Quantity
Subtotal
A-Frame ($10 each)
Wind-Master ($20 each)
Total
Parking Staff Assistance
Total Parking Staff Needed
# of Parking Staff
Hours (Min. 4 hrs)
Subtotal
Hourly Rate $25
Contact Information
Permits must be picked up from the SciTech Campus Parking Services Office unless other arrangements have been made.
Orders are processed and available for pickup within 48 hours between Monday - Thursday.
Credit cards are accepted only in the Parking Services Office.
Name
*
First Name
Last Name
Department
*
Email
*
Phone
*
Grand Total
Please select a payment method
*
Mason Org Code
Cash or Check
Credit Cards
Mason Org Code
*
Please select a delivery method
*
Pick up in person
Deliver to an on-campus office (3-5 business days)
Please enter the mail stop#
*
Additional Comments
I am placing this order with the understanding that there are no refunds available for permits. I attest that I am authorized to make this transaction.
*
I agree
Signature
*
Submit
Should be Empty: