Application for Residential Parking Permit

It is your responsibility to ensure that all required information is provided.  The Police Dept is not responsible for notifying you that your application will not be processed due to an insufficient application.  By completing this application, you acknowledge that you have read and understand the Residential Parking Permit Policy.

Today's Date (mm/dd/yyyy)	*
Your Email Address	*
Your Full Name	*
Your Date of Birth (mm/dd/yyyy)	*
Your Phone Number	*
Address Line 1	*
Address Line 2
City	*
State	*
ZIP Code	*
Please select	*	I am applying for a new residential parking permit I am renewing an existing residential parking permit
If renewing your permit, indicate your current Permit #
Vehicle License Plate Number	*
Vehicle License Plate Number
Check here if you would also like a Guest Parking Permit		Yes, please mail me a Guest Parking Permit
Use the File Upload Section to provide us with proof of residency. This could include scanned copies of utility bills (water, gas, electric), a lease agreement, etc. Any questions on approved documents should be directed to pdclerk@glenwoodpolice.com. Failure to provide acceptable proof of residency with your application will result in your application being rejected.
File Upload	*
File Upload
Security Code	*