Instructions for Resident with Disability

Instructions for Resident Who Requires a Nurse or Attendant

1.Complete a Nurse/Attendant Information Form (on reverse side) for each nurse/attendant who will need access to your room/apartment. Submit completed form to Kathleen Gardner, Associate Director of Residence Life, SIUE Campus Box 1254. Please allow two business days for processing.

2.An Entrance Card will be issued to each nurse/attendant working at a residence hall so they can swipe at the front desk. The Entrance Card must be returned to the Front Office at the end of the academic year or at the end of employment, whichever comes first. A $10.00 charge will be assessed to the resident for any unreturned card.

3.Nurse/attendant needs to park their vehicle in the residential lot that corresponds to where the resident lives. Tickets will be issued to vehicles parked in metered spaces without sufficient payment or to vehicles parked in spaces designated “Staff Parking”.

Additional Note from Parking Services: Residents who have state-issued disability hangtags, parking cards, or plates are required to purchase and display SIU Edwardsville parking permits in order to use parking spaces for individuals with a disability on University property. A verification process to ensure that the purchaser and the person to whom the parking card/license plate has been issued are one and the same may be conducted. Vehicles with appropriate permits may be parked in handicapped spaces only when individuals with a disability are the driver or rider in the vehicle.

4.The resident is to contact the Front Office when a nurse/attendant is no longer employed by the resident so that their name can be removed from the parking approval list.

NURSE / ATTENDANT INFORMATION FORM

** Please complete one form for each nurse/attendant

Today’s Date:______

Resident’s Name: ______

Resident’s Campus Address:______

Resident’s Phone Number:______

Resident’s Student ID #:______

Nurse/Attendant Name: ______

Nurse/Attendant SSN:______

Agency: ______

Agency Phone Number: ______

Vehicle Year:______

Vehicle Make/Model: ______

License Plate State/Number:______

Please list the times that the Nurse/Attendant will be visiting the resident for each day:

Sunday ______Monday______

Tuesday______Wednesday ______

Thursday______Friday______

Saturday______

University Housing Office Use Only:

Entrance Card # ______Issued on (Date) ______Returned on (Date) ______

Vehicle information sent to Parking Services on (Date) ______Vehicle removed from list on (Date)______

Copy: Resident; Disability Support Services; Parking Services; Hall/Residence Director; file