Get Earc Issued Disabled Parking Request Form - San Jose State ...

This guide provides clear and supportive instructions for completing the EARC issued disabled parking request form online. Following these steps will help ensure that you provide all necessary information to properly request disabled parking accommodations.

Follow the steps to fill out the EARC issued disabled parking request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the contact information section. Provide your name, employee ID number, home address including street, city, state, and zip code, as well as your home phone, work phone, cell phone, and email address. Indicate your preferred method of contact by checking all applicable options.
3. Fill out the employment information section. Indicate your employment status (full-time or part-time) and specify your role—faculty or staff—by selecting the appropriate options. Provide your job title, department, building/room, and college/division.
4. In the disabled parking request information section, clearly state the condition(s) that necessitate your request for disabled parking. Describe them thoroughly to support your application.
5. Next, indicate the specific dates for which you are requesting disabled parking.
6. Carefully read the EARC issued disabled parking request agreement and certification section. Sign and date the form to affirm your understanding and agreement.
7. In the consent to release information section, authorize the EARC to contact your treating professional or physician regarding your medical condition(s). Fill in their name, medical facility, address, city, state, zip code, and phone number.
8. Finally, make sure to sign and date the consent form to finalize your request.
9. After completing the form, save your changes, and choose to download, print, or share the form as necessary.

Complete your EARC issued disabled parking request form online today to ensure your accommodations are in place.