Teacher Permit Application Form

LONDON BOROUGH OF MERTON

TEACHER PERMIT APPLICATION FORM

All sections must be completed by the Head Teacher of the School, please use CAPITAL LETTERS.

TITLE (e.g Mr/Mrs/Miss/Ms) SURNAME FIRST NAME

SCHOOL ADDRESS

TELEPHONE NUMBER:

VEHICLE REGISTRATION NUMBER

MAKE/MODEL COLOUR

TYPES OF SCHOOL PERMITS AND PRICES - please tick appropriate box.

Annual Permit:

£188.00

Specific Term Permit:

£63.00 PER TERM

Please Note:

· Teacher Permits will only be issued where there is spare capacity within the zone that the school falls within.

· All Schools applying for a permit must have an up to date School Travel Plan (STP)

· The council reserves the right to withdraw school permit provisions or reduce the number of permits if there is a change in on-street parking demand, or the school holds an out of date STP.

It may be necessary from time to time to suspend parking bays for emergency purposes, utility works, etc and it is the permit holder’s responsibility to check whether bays have been

suspended. A Penalty Charge Notice may be issued to any unauthorised vehicle parked in a suspended bay.

Data Protection

We hold and process personal information in accordance with the requirements of current data protection legislation. We will use the information you have supplied to process your application. We may also disclose it to bodies responsible for auditing or administering public funds. For more information see http://www.merton.gov.uk/how-we-use-your-information.

Full Signature

Name

(in block capitals)

Return Completed form to: Parking Services,

Merton Civic Centre, Date

London road, Morden

Surrey SM4 5DX

PAYMENT:

If you would like to pay for your permit using our online payment system please provide your email address below and we will email you a link to do this once your application has been approved and the permit has been set up on the system:

Email:

Alternatively we will contact you to take payment over the phone, please provide your contact telephone number in the space provided:

Telephone No:

If you would like to pay by cheque or postal order please make payable to the London Borough of Merton. Please write the applicant’s name and address on the reverse of the cheque.