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Get Canada Accessible Parking Program Permit Application Form Individual - City Of Kelowna 2016-2024

Ou applied for a City of Kelowna parking permit before? YES NO If yes, permit # Mr. Mrs. Ms. Dr. Last Name: First Name: Middle Initial: Address: City: Postal Code: Phone: Email Address: 2. PHYSICIAN ASSESSMENT Medical Name of Disabling Condition(s) Patient eligibility (Please check one) Prognosis (Please check one) Disability that specifically affects mobility and the ability to walk Permanent (Permit Can NOT walk 100 meters without risk to heal.

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