MONTHLY SUBSCRIPTION ORDER FORM Parking Location InformationTentative Start Date* MM slash DD slash YYYY Please note this is a tentative start date, the sign up process takes 24-48 business hours and may push your start date back based on submission and processing times. Secure Parking will reach out with your exact start date by email once your account has been made. If you need parking prior to confirmation of start date you will need to pay the daily rate.This field is hidden when viewing the formLocation Data1140~MN~Centre Village Parking Ramp - Lower~Tenant Reserved Space~~~Minneapolis~0~Secure Parking USA~~1~1~01141~MN~Centre Village Parking Ramp - Lower~Public Reserved Space~272.00~~Minneapolis~0~Secure Parking USA~~1~1~01142~MN~Centre Village Parking Ramp - Lower~Tenant Standard Space~~~Minneapolis~0~Secure Parking USA~~1~1~01143~MN~Centre Village Parking Ramp - Lower~Public Standard Space~180.00~~Minneapolis~0~Secure Parking USA~~1~1~01137~MN~Centre Village Parking Ramp - Upper~Public Reserved Space~248.00~~Minneapolis~0~Secure Parking USA~~1~1~01138~MN~Centre Village Parking Ramp - Upper~Public Standard Space~155.00~~Minneapolis~0~Secure Parking USA~~1~1~01139~MN~Centre Village Parking Ramp - Upper~Tenant Standard Space~~~Minneapolis~0~Secure Parking USA~~1~1~01145~MN~Gateway Parking Ramp~Reserved Space~208.00~~Minneapolis~0~Secure Parking USA~~1~1~01146~MN~Gateway Parking Ramp~Standard Space~155.00~~Minneapolis~0~Secure Parking USA~~1~1~0This field is hidden when viewing the formParking OperatorSelect Parking OperatorAtlantic ParkingCity*Select a StateGAILMONCOHOKPASCTNTXWILocation* 1 Month PlanRecurring Subscription 3 Month PlanRecurring Subscription Parking Plan* First Choice Second Choice Third Choice This field is hidden when viewing the formDocument Type*Quantity of Parking Spaces to Purchase*1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950*You will be billed the monthly subscription rate per number of parking spaces selected. I acknowledge that this tenant discounted monthly parking rate is valid for 12 months and is subject to a price increase after the 12 month period* I Understand Account Type*Individual AccountCompany AccountAdd a Subscription to an Existing AccountPromo Code (If Applicable)Your promotional discount will reflect on your invoice. You will not see the discount applied on this signup form. Who was your sales representative?Select OneM. KarabinH. FisherM. LemonS. GermirliK. WysockiT. RupertR. BartlettM. LunsfordThis field is hidden when viewing the formHow did you hear about us?*Select OneFacebook/Twitter/InstagramFlyer/MailerGoogleI currently daily parkReferred by CompanyReferred by friend or coworkerReturning customerSecureparkingusa.comSignage at the lotOtherContact InformationName* First Last Email* Phone*Company Name List of ParkersParker First Name*Parker Last Name*Plate Number*Vehicle Plate State*Select StateALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTMDNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYMobile PhoneTX Toll TagAdd Another VehicleRemove VehicleNote: For each space purchased a primary and secondary vehicle can be associated with the account. The vehicles must be associated with the same parker, spaces cannot be shared between parkers. If you do not have the vehicle information at this time, please ensure that it is submitted updated on your account prior to the start of your parking to prevent any issues.Terms & Conditions* I accept the Terms & Conditions View Terms & Conditions
