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2. City of Fredericksburg Monthly Parking Access Card Application
   To complete this application, fax a copy of a voided check to (540) 372-1152. Please use "Monthly Parking Card Application" as the subject line on your cover sheet. Application may also be made in person at City Hall or the Sophia Street Parking Garage. Please allow 48 hours for processing. If you have questions about your application, please call the Fiscal Affairs Department at (540) 372-1017.
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Email Address*
15. Home Phone Number*
16. Cell Phone Number*
17. Business Phone Number*
19. Name of Employer*
21. Employer Address*
23. City*
24. State*
25. Zip*
27. Vehicle #1 Make*
28. Year and Model*
30. License Plate Number*
31. State*
33. Vehicle #2 Make (Optional)
34. Year and Model
36. License Plate Number
37. State
39. Emergency Contact*
40. Phone Number*
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

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