US Army Corps of Engineers ®

Day Use Pass Order Form Print and mail this form when ordering Day Use Pass. Sorry, Golden Age and Golden Access Passport discount passes cannot be sold through the mail.   Date: _________________________  Name:  ___________________________________________________________ Address:  ___________________________________________________________ City, State Zip:  ___________________________________________________________ Phone:  ___________________________________________________________ What Do You Want To Purchase? - Fill in number of passes and fill in amount due. Item # of Passes Cost Per Pass Due Annual Day Use Pass   $30.00   TOTAL  $ Vehicle Information for Day Use Pass - Provide license plate number for each pass requested. License Plate # State Pass Pass Number (Internal Use Only)     Day Use Pass #1       Day Use Pass #2       Day Use Pass #3   Payment - Include driver's license number. Make check payable to "FAO, USAED, Portland" Check Only Amount Check Number Driver's License Number $     Do Not Send Cash. Send check or money order. Make checks payable to: "FAO, USAED, Portland" Mail request and payment to: Portland District, Corps of Engineers PO Box 2946 Portland, OR 97208-2946 Attn: CENWP-OD-SR