required Name Please include your full legal name Phone Email Address City/State/Zip Vehicle Information License Number and State Make, Model (e.g., 4-door) & Color Type of Parking Requested – Prices as of July 1, 2016 NUNM lot - $36/month (21 or more hours/week)NUNM lot - $18/ month for part-time employees (11-20 hours/week)NUNM lot - Visitor (for adjunct faculty and employees who work 10 or fewer hours per week – no charge) Supervisor's Name Acknowledgment Lot and street hangtags are the property of National University of Natural Medicine and must be returned to the Facilities Office when no longer in use (this also allows your parking fee deductions to be stopped). I understand that I am responsible for the hangtag, its use and its return. I authorize NUNM to deduct the parking fee for the type of parking noted above from my paycheck, and understand that parking charges may change in the future. This form allows continuing payroll deductions at the then current rate until the hangtag is returned. NUNM is not responsible for damages to or loss of vehicle, its contents or accessories from any cause whatsoever. I have read and agree to the above statement.