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ST Renewal Form

Sustainable Transportation - Open Enrollment

*Attention Carpoolers: Carpool Permits expiring June 30th will be valid (if displayed properly) through July 11th to allow time for the mailing process.*

Do I qualify for ST incentives?
If your current employment appointment expires on June 30 2008, click here.

Please fill out the following form for ST Renewal. (All fields are required)

   
Employee Name: First
Last
Employee ID: (what's this?)
Campus Room No./Building Name:
Zot Code:
Phone Number:
Commute Mode:
Preferred Incentive:
       ST Kiosk Pickup Parking Permits (click for picture)
       ST Hangtag Parking Permit (click for picture)
       Greenhouse Cash (for cyclists and walkers- the modes with no carbon footprint- only)
Email Address:
Delivery Option:
(Greenhouse Cash Only) 		I will pick up my Greenhouse Cash at the Parking and Transportation Services Office (200 Public Services Building)
Please mail my Greenhouse Cash to my campus address (above.) NOTE: Greenhouse Cash is mailed ONLY to campus addresses. Any Greenhouse Cash lost in the mail will not be replaced.
Payroll Coordinator's Name:
Terms & Conditions:
 I do not have a long-term (one month or more) non-carpool parking permit
I am a current UC Irvine employee with a 50% or greater appointment
If I leave the program before July 2009 I agree to return or pay back the incentives for the remaining months (incentives will be charged at full value of incentive [$10/day for permits, face value of cash])
I realize I can qualify for incentives from only one rideshare program/year


You must agree to the terms and conditions listed by checking all of the boxes above in order to submit this application.
**Employees with an employment appointment of less than a year must re-register for the ST program in the Parking and Transportation Services Office during the year. Incentives are not automatically sent to participants during mid-year.**

Participation in UCI's Sustainable Transportation Program is a privilege and not a right of employment or enrollment at UCI. Sustainable Transportation Management may refuse participation privileges to anyone who does not meet qualification requirements.

Failure to practice good conduct or abuse of incentives may result in revocation of program participation and incentive privileges.

Parking Model & Principles
UCI Parking and Transportation Services
200 Public Services Building
Irvine, CA 92697-4525

Phone: (949) 824-7486
Fax: (949) 824-2387
Office Hours: Monday - Friday 7:30 AM - 4:00 PM

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