Value Card Program Enrollment

This form is for employees who want to switch from a standard deduction to a pay-per-use deduction. Please note: You are only allowed to enter/exit the lot once per day. Any additional entrances/exits will count toward your monthly usage.

View Parking Rules and Regulations here.

Phase 3 Parking Program Form Heading link

Name * Required
First Last
UIN * Required
UIC Email * Required
Phone * Required
Current Lot * Required
Pay Frequency * Required
Amount * Required
Value Card Submission Effective: * Required
MM slash DD slash YYYY

Must be after today's date.
Please read the following: * Required
I agree to the policy below.
I consent to switch my standard parking deductions to the Value Card plan deductions. I certify the above information to be true and correct. I agree to abide by the regulations governing parking on UIC property which have been provided to me.

I understand that I am responsible for parking fees for this assignment until the expiration date, unless canceled by me in accordance with parking regulations.

Per IRS regulations, parking deductions are taken pre-tax and are not refundable.

I authorize the University of Illinois at Chicago to tow and store, at my expense, any vehicle registered, owned, or operated by me that is parked in violation of campus parking regulations or posted signs.
Email
This field is for validation purposes and should be left unchanged.

Value Card Program Enrollment

Phase 3 Parking Program Form Heading link Copy link

Phase 3 Parking Program Form Heading link