Parking Permit Application Form 停車證申請表

Parking Permit Application Form
停車證申請表
When applying for next year's permit at the end of the year, please enter the 1st day of next year in the "Application Date" field.

於年底申請明年的停車證時，請於「申請日期」欄位輸入明年的一月一日。
Application Date 申請日期

MonthDayYear
When applying for next year's permit at the end of the year, please enter the 1st day of next year. 於年底申請明年的停車證時，請輸入明年的一月一日。
Reason for parking permit 申請原因（Permit Eligibility 申請資格）*

Pregnant 孕婦Young child (under 2 years old) 有2歲以下幼兒Temporary disability or physical limitation (with doctor's note) 暫時殘疾或身體限制 (需醫生證明)Short-term disability or injuries (without a doctor's note or government placard) 短期殘疾或受傷（沒有醫生證明或政府殘障停車牌）Handicap (with government placard) 殘障 (需政府授權的殘障停車牌)Senior: 70 years old and over 老年人：70歲以上
Name 姓名*

First Name 名Last Name 姓
Email 電子郵件*
example@example.com
Phone Number 電話號碼*
I attend 我參與*

English Service基督福樂之家 Chinese Service
Small group or Community 所屬小組
License Plate # 車牌號*
Car 汽車*

Make 品牌Model 型號Color 顏色
- I agree to parking permit terms & conditions 我同意停車證條款
  
  Applicant’s Signature 申請人簽名: ____________________________ Date 日期: ___________________
- Online Form
  掃碼填表
- Should be Empty: