Daily Parking Request Form

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DAILY PARKING REQUEST FORM
Columbia Nano Initiative (CNI-CISE)
Main Number: 212-854-3265 Fax: 212-854-1909
Submit Electronic Request to
cise@columbia.edu
Schools and administrative departments may request daily parking for visitors to campus participating in classes, meetings, and
events and for faculty and administrators in connection to a specific University business purpose. When available and assigned,
a $15 daily charge will be billed against the ARC Chartstring provided.
Due to the extremely limited parking space available at Morningside, it is imperative that all requests are made two
business days; earlier requests are greatly appreciated. Requests made one business day or later will be accepted and
processed but availability is not guarantee. Please be aware Same-day emergency requests, will carry an additional
$15.00 charge.
Individual Making the Request (Not parker):
First Name: _____________________
Last Name: _________________________
Email Address: __________________
Phone Number: ______________________
Individual (parker) Information:
First Name: _____________________
Last Name: _________________________
Email Address: __________________
Phone Number: ______________________
Parking dates requested:
From: ___________
Until: ___________
Approximate Time:
From: ___________
am
pm
Until: ___________
am
pm
Vehicle Information:
Car Make: ____________________Car Model: _______________Color: _____________
Plate #: _______________________State: ______________
Reason for parking request:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Dept
PC Bus Unit
Project
Activity
Intitiative
Segment
Fund
Function
Unit
COLUM
Requested By: _____________________ Email: ______________________
Approval Signature: ____________________Print Name: ____________________
Request Received: _________ Request Reviewed By: __________ Request Processed: ___________
Reference #
Reconciled Amount
Reference #
Reconciled Amount
OFFICE USE
ONLY
Reference #
Reconciled Amount
Reference #
Reconciled Amount

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