UTC Employee Parking and Facilities Access Form

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University Town Center

UTC Employee Parking and Facilities Access Form

Welcome to a new semester at UTC! Please complete this form to receive a parking access card.

-Printing/Copying/Scanning: Please use your PGCC login information to print, copy, and/or scan.

-Lockers: Access the Faculty workroom 253 with cipher code 135. Lockers remain open for use, at the end of the academic year, you must resubmit this form for next year or empty the locker. Please bring a lock to secure your items. Add your name to the white tag to identify your locker. Locks will be removed if no communication is received.

First Name

Last Name

User ID

I am:

Faculty

Staff

I am a

Full-Time Staff or Instructor

Part-Time Staff or Instructor

Best Phone Number to reach you:

e.g. (999) 999-9999

Full Home Address (This information will be kept confidential.)

Your Department and Department Secretary

List the class(es) you will be teaching:

Spring

Summer

Fall

N/A

Semester(s) you will be teaching at UTC (Select N/A if not applicable):

Classroom or Office Number, i.e. Classroom #142 or Office #205 (Comment 'N/A' if not applicable)

UTC Class Days and Times, i.e. Tuesday/Thursday 6:00 - 7:15 pm (Comment 'N/A' if not applicable)

Face-to-face (F2F)

Remote

Hybrid

Hyflex

N/A

Course Teaching Format:

Office Hours (Comment 'N/A' if not applicable)

Assigned Parking Access Card Number, if known (The first 4-5 numbers on the parking pass)

e.g. 9999999999

Vehicle Make, Model, color, & license plate number

I understand that I am responsible for the cost (currently $20) of replacing any lost or stolen parking access cards. I understand that I must return the parking access card by the day that grades are due at the end of the semester, or my department chair will be notified. Parking access cards not returned will be charged a $20 fee. Money order or check should be made payable to Atlantic Parking.

Yes, I fully understand

No, I do not understand, I would like to speak with someone.

Thank you for completing this form and we wish you a wonderful year!

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