Airport Residential Parking Card

PMB 22 Newman WA 6753

Ph: (08) 9175 8000

Office Hours Mon-Fri 8:30 to 4:30

Please sign and then attach these
Terms and Conditions to your
application:

Full Name*

Address

Street Address:*

Town:*

State:*

Post Code:*

Country:*

Contact Number*

Email*

Proximity Card Required*

Proof of Identity*

Max File Size: 10.00 MB
Allowed File Types: .jpeg, .jpg, .pdf, .png

Proof of Local Residency*

Max File Size: 10.00 MB
Allowed File Types: .jpeg, .jpg, .pdf, .png

Existing Card Number (if applicable for renewal)

I have attached the Terms and Conditions that are located at the top of this form*

Max File Size: 10.00 MB
Allowed File Types: .doc, .docx, .jpeg, .jpg, .pdf, .png

Declaration*

I declare that all information provided is true and correct and understand it is against law to falsely provide incorrect information.

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