(*) Required fields
(**) Either House Name OR House Number is required
Please select your Title
Please fill in your Firstname
Please fill in your Lastname
Please fill in your email
Please fill in your email again for confirmation
Please enter a username (your email address)
This should be a valid email address
Please enter a password
Please confirm your password
Please select your Employer
Please fill in your Employer
Please supply your evidence for requiring a Visiting Specialist permit
Please fill in your Job Title
Please select your Department
Please fill in your Department
Please select your Base
Please fill in your Base
Please select your home postcode
Please fill in why you should be considered for a Car Park Permit.
Please fill in House/Flat Number (numbers only i.e. '23' in '23a' )
Please fill in House/Flat Name (i.e. if there is no number)
Please fill in your road/street
Please fill in City
Please fill in your
Postal Code
Please fill in your Work Telephone Number
Please fill in at least 1 Vehicle Registration Number
Please choose the Permit Required
Title*
Select...
Mr Mrs Miss Ms Dr
Your Home Address
House Name **
First Name*
Number **
Last Name*
Number extension
Email Address*
Road/Street*
City/Town*
Confirm Email*
Postal Code*
Email does not match!
Email invalid!
Validating Email...
Email Valid
A user already exists with this email address.
Password*
Confirm Password*
Employer Information
Employer*
Select...
ASPH - Trust/Substantive employees Bank - Employed by the staff bank/Bank On Us Non Trust Staff - Locum/Agency, Employed elsewhere Other - Please indicate Student - Non paid placement Visiting Specialist - Employee who pays parking at another trust Volunteer -Voluntary team member
Evidence of permit payment at other Trust shown/sent *
Job Title*
Department*
Select...
Accident & Emergency Admissions Anaesthetic Angiography (Lister In-Health) Ante Natal Clinic Appliances Ash Ward Ashford Health Centre Aspen Ward Audiology Biochemistry Birch Ward Blanche Heriot Unit Bone Densitometry CAMHS Cancer Services Cardiology Catering Services Cedar Ward Central Booking Office Chaplaincy Chaucer Ward Chief Executive & Directors Childrens Services/Paediatrics Community Midwifery Complaints Coronary Care Unit Day Surgery Unit - Ashford Day Surgery Unit - SPH Dermatology Diabetes Diatetics Dickens Ward Discharge Lounge ECG Endoscopy ENT Estates Eye Unit Facilities Falcon Ward Fielding Ward Finance First Steps Nursery General Medicine General Surgery GP Haematology Healthroster Histopathology Holly Ward Hotel Services Housekeeping Services Human Resources I.T.U. Infection Control Information Management & Technology Intermediate Care Team Joan Booker Ward John Kingfisher Ward Labour Ward / Delivery Suite League of Friends Maple Ward Maternity May Ward Medical Assessment Unit Medical Equipment Medical Records - General Medical Secretaries Medihome Mental Health Services MHDU Microbiology Midwifery Mortuary MRI (Alliance Medical) Neo Natal Unit Neurology NHS Supplies NHSP Nuclear Medicine Nursing Oak Ward Obstetrics & Gynaecology Occupational Health Occupational Therapy Occupational Therapy OCS Operations Offices Oral Surgery & Orthodontics Orthopaedics & Trauma Outpatients Department Pathology Patient Affairs Payroll Performance Pharmacy Phlebotomy Physiotherapy Portering Post Graduate Medical Centre Press Office Quality Rheumatology Rowley Bristow Ward East Rowley Bristow ward West Secamb (South East Coast Ambulance) Security SHDU Social Services Speech/Language Therapy Sterile Services Surgical Assessment Unit Surrey and Borders Mental Health Services Surrey Community Health Swift Ward Teaching School Telecomms Theatres - Ashford Theatres - SPH Transitional Care Unit Transport Travel Planning Urology Volunteers Wordsworth Ward X-Ray Other...
Your main base*
Select...
Ashford St Peter's
Your permit will be available for collection here.
Home Postcode*
Not In exclusion zone
In Exclusion Zone
If you live within the exclusion zone but require a permit please supply details below. *
Emergency Contact Information
If your vehicle needs to be moved or is damaged, we will need to contact you in a hurry Please be aware that your Work/Day number will be visible on your work permit.
Work/Day Telephone*
(this number will appear on your permit)
Pager
Mobile
Bleep
Vehicle Registration Number
Vehicle 1 Registration*
Vehicle 2 Registration
Permit Type Required
*
information...
Red permit
Gold permit