STANFORD UNIVERSITY PARKING & TRANSPORTATION SERVICES

2010-11 BIKE AND CLOTHING LOCKER RENTAL APPLICATION

WHO ARE YOU? (Proof of Stanford affiliation required) CHECK ONE BOX BELOW
Name (Last name, First name) University employee
Hospital, LPCH, or Clinics employee
Daytime phone Stanford ID number/Hospital ADP ID* Resident student
Visiting scholar
BIKE AND CLOTHING LOCKER RENTAL

Commuting student
Full email address Postdoc
Other (sponsorship form required)
* If you don’t know your ADP ID, please contact the Hospital Parking Liaison at 650.723-4748.

LOCKER TYPES AND LOCATIONS (see map of locker and shower locations)

Start date: ______________________________

Clothes locker ($16/year; prorated at $4/quarter, beginning Nov.) $

New rental Renewal Bldg. 500 Porter Varian Physics • MSOB •
Bldg. 550 Sweet Hall Gates Stanford Hospital •
Bldg. 590 School of Edu./Cubberley Beckman • Clark Center •
Locker number _________________ • indicates shower in building. Accessible only during normal business hours

Bike locker for commuting ($24/year; prorated at $2/month, beginning Nov.) $

New rental (requires refundable $25
key deposit. Refund given within five HOSPITAL AREA CAMPUS AREA
days after return of key) Bicycles must be PCH Falk Center (PNE) Gates
Renewal registered for use
SIM1 Cancer Center (CC) Meyer Library Y2E2
of bike lockers
LKSC Cafeteria entrance (C) Memorial Way / Alumni
Locker number _________________

Enclosed bike cage structure ($24/year; prorated at $2/month, beginning Nov.) $

Parking Structure 3 Parking Structure 5
New rental Renewal
Beckman (Basement level. Accessible only during regular business hours)

ALTERNATE CHOICES
Clothes lockers and bicycle storage lockers are in limited supply, and non-motorized commuters have priority. Even if you don’t
own a parking permit, your first preference may not be available. However, we will try to accommodate you at another location.
If there are no lockers available in my preferred location, please assign me a locker in:

2nd choice ______________________________________________ 3rd choice ___________________________________________

WAITING LIST (if none of my choices are available) PAYMENT METHOD

I don’t want to wait – please refund my money. Cash (Do NOT mail)
Please put me on the waiting list for my preferred locker location.* Check (make payable to “Transportation”)
* If you are waiting for a bike storage locker, you will receive highest priority if you
are willing to forgo use of a parking permit when a locker becomes available. Credit Card (Visa/MasterCard ONLY)
I am willing to do without a permit when a bike storage locker Do NOT fax or mail credit card information.
Submit application, then call P&TS at
becomes available. 650.723.9362 to provide the information.

AUTHORIZATION AND SIGNATURE

I understand that I have rented this locker from Stanford University Parking & Transportation Services exclusively to store a
bicycle, articles of clothing, and other materials needed to facilitate non-motorized commuting, and that non-motorized commut-
Revised 8/10

ers have priority for these lockers. I also understand that Parking & Transportation Services has the right to inspect the lockers
at any time without previous notice to ensure that they are being used properly. Stanford University will not be held liable for any
loss, injury or damage arising from the use of these lockers.

x ____________________________________________________________________________
SIGNATURE OF RENTER
________________
DATE

Mail: 340 Bonair Siding, Stanford CA 94305-7255 MC: 7255 Email: parkingoperations@stanford.edu Phone: 650.723.9362 Fax: 650.724.8676
transportation.stanford.edu