SUBMIT COMPLETED FORM TO THE PARKING & TRANSPORTATION SERVICES OFFICE.
601 SOUTH COLLEGE ROAD • WILMINGTON, NC 28403-5914 • 910-962-3178 • WWW.UNCW.EDU/PARKING
University of North Carolina Wilmington
ϮϬϭϱͲϮϬϭϲFaculty/Staff Carpool Vehicle Registration Form
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Information and Rules:
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
The Carpool Program requires a minimum of two participants.

All participants and all of their vehicles must be registered on the Faculty/Staff Carpool Registration form to be associated with the
carpool program.

A primary driver must be designated and is responsible for the use of the permit. The primary driver is issued the permit. The permit is
then to be displayed in whichever vehicle is parked on campus.

Participants may carpool with permanent employees in a different pay range; each individual is charged based on their respective pay
range.

All participants within a carpool must purchase a parking deck permit to use the parking deck. The parking deck is an optional location
and carpoolers may also use faculty/staff lots.

The cost of the permit per participant is half of what their permit would be according to their salary tier.

In addition to the primary permit, the primary driver will receive 10 scratch off day passes to be distributed between the other
participants for use when carpooling is not feasible. Additional scratch off day passes can be purchased for $5 each.

Misuse of the carpool program will result in revocation of carpool permit.
Example
Name
Jane C. Doe
University ID (850#)
850999999
Department Name
Auxiliary Services
Department Mailing Code
5914
Campus Phone Number
962-9999
License Plate State
NC
License Plate Number
ABC123
Vehicle Make
Ford
Vehicle Model
Explorer
Vehicle Color
Space Type & Monthly Cost
Black
(Select from the chart below)
Primary Driver
Carpooler #2
Carpooler #3
Carpooler #4
3 Carpoolers
Monthly Cost
(Annual Cost)
$4.05 ($48.60)
$8.05 ($96.60)
$11.38 ($1ϯϲ͘ϱϲ)
$14.44 ($1ϳϯ͘Ϯϴ)
$6.13 ($73.56)
$10.13 ($121.56)
$13.47 ($1ϲϭ͘ϲϰ)
$16.52 ($19ϴ.Ϯϰ)
4 Carpoolers
Monthly Cost
(Annual Cost)
$3.04 ($36.48)
$6.04 ($72.48)
$8.54 ($ϭϬϮ͘ϰϴ)
$10.83 ($12ϵ.ϵϲ)
$4.60 ($55.20)
$7.60 ($91.20)
$10.10 ($ϭϮϭ͘ϮϬ)
$12.39 ($14ϴ.ϲϴ)
Standard Space
$12.08
Office Use Only
Permit Number
Space Type
Standard Space
Standard Space
Standard Space
Standard Space
Deck Space
Deck Space
Deck Space
Deck Space
1ϲC9999
Salary Tier
$25,000.01 - $40,000.00
$40,000.01 - $65,000.00
$65,000.01 - $90,000.00
$90,000.01 - $999,999.00
$25,000.01 - $40,000.00
$40,000.01 - $65,000.00
$65,000.01 - $90,000.00
$90,000.01 - $999,999.00
2 Carpoolers
Monthly Cost
(Annual Cost)
$6.08 ($72.96)
$12.08 ($144.96)
$17.08 ($ϮϬϰ͘ϵϲ)
$21.66 ($25ϵ͘ϵϮͿ
$9.20 ($110.40)
$15.20 ($182.40)
$20.20 ($2ϰϮ͘ϰϬ)
$24.79 ($29ϳ.ϰϴ)
I, the undersigned, agree to abide by all regulations, ordinances and laws governing the safe and lawful operation and parking of a motor vehicle
on the campus of UNCW including payment of citations and fees. Note: Registration is not complete until the parking permit is displayed in
accordance with prescribed regulations.
Signatures:
Primary Driver: ___________________________Date: __________
Carpooler #3: ___________________________Date: __________
Carpooler #2: ___________________________Date: __________
Carpooler #4: ___________________________Date: __________
Rev. 08/2015