ARLINGTON VALIDATION FORM

 

 Please complete this form and click the submit button at bottom of this page.

 

Phone: Ext. 3-8146,  or  3-2065 with any questions

 

NAME OF THE EVENT:           DATE OF THE EVENT:

EVENT START TIME:                  EVENT END TIME:

NUMBER OF VEHICLES EXPECTED:

 

OUR DEPARTMENT WOULD LIKE TO ORDER THE FOLLOWING:

PARKING VALIDATION

FOUNDATION PARKING DECK  ALL DAY $ 7.00    QUANTITY:   TOTAL:

 

FOUNDERS HALL VALIDATIONS

ONE HOUR $3.00                            QUANTITY:     TOTAL:

TWO HOURS $6.00                        QUANTITY:     TOTAL: 

THREE HOURS $9.00                    QUANTITY:     TOTAL:

FOUR HOURS $ 12.00                       QUANTITY:     TOTAL:

OVER 4 TO 24 HOURS $14            QUANTITY:     TOTAL:

WEEKEND DAILY RATE $7.00    QUANTITY:     TOTAL:

 

MANPOWER: $25 /HOUR 4 HOUR MINIMUM

NUMBER OF ATTENDANTS: HOURS: TOTAL:

 

 

NAME:         DEPARTMENT: MSN:
 

PHONE:    PLEASE SEND BILL TO:      Org Code #:


I AM PLACING THIS ORDER WITH THE UNDERSTANDING THAT THERE ARE NO REFUNDS AVAILABLE FOR VALIDATIONS.
 

I ATTEST THAT I AM AUTHORIZED TO MAKE THIS TRANSACTION.

FIRST NAME:                 LAST NAME: