Access passes will display a number which will correspond to the individual's name, property address and applicable identification documents as submitted with an application. Passes allow access to the barrier island providing that it is safe to do so.  More importantly, passes do not guarantee access to the barrier island; access will be strictly controlled at the discretion of the Police and Fire Rescue Departments.

Passes and renewal stickers must be picked up at the following address:

Fort Lauderdale Police Department
1300 W. Broward Blvd
Fort Lauderdale, Florida 33312 

Ph: (954) 828-5703

CHANGE NOTIFICATION: BARRIER ISLAND INCIDENT ACCESS PASSES

All hotel/motel operators will retain the same pass/placard number from last year. Renewing applicants are still required to submit an online application form each year.

Applicants will be notified of approval via email when stickers or passes are ready for pick up.

For renewed applications, property representatives must bring their old pass(es) to the Police Department for staff to adhere the new sticker(s).

Please contact us if more clarification is needed.

Thank you for your understanding. 

1

Hotel/Motel Contact Information

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Hotel/Motel Contact Information

Property Name	Number of Employees	Number of Rooms
Property Address	City	State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code	Property Phone Numberext.

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2

Management Applicant 1 - Contact Information

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Management Applicant 1 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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Management Applicant 2 - Contact Information

Management Applicant 2 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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Management Applicant 3 - Contact Information

Management Applicant 3 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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5

Management Applicant 4 - Contact Information

Management Applicant 4 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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Management Applicant 5 - Contact Information

Management Applicant 5 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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7

Shuttle Driver 1 - Contact Information

Shuttle Driver 1 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

8

Shuttle Driver 2 - Contact Information

Shuttle Driver 2 - Contact Information

First Name	Last Name	Position
Employee ID number	Work Phoneext.	Cell Phoneext.
Work Email Address	Alternate Email Address	Gender
Driver License Number	Issuing State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Copy of Driver License Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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9

Name of Person picking up the passes

Pick up Access Passes at Police Department, 1300 W. Broward Boulevard, Fort Lauderdale, FL 33312

Name of Person picking up Access Pass

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10

Electronic Signature:

I certify that the information in this online application is true and complete to the best of my knowledge. I also grant permission to the Fort Lauderdale Police Department to verify the information that I provided. I understand that all Barrier Island Incident Access Passes remain the property of the City of Fort Lauderdale and may be revoked if used inappropriately.

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Electronic Signature: I certify that the information in this online application is true and complete to the best of my knowledge. I also grant permission to the Fort Lauderdale Police Department to verify the information that I provided. I understand that all Barrier Island Incident Access Passes remain the property of the City of Fort Lauderdale and may be revoked if used inappropriately.

Electornic Signature ( Enter First and Last Name)

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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