Student Parking Structure Application
PLEASE NOTE THIS APPLICATION IS FOR THE PARKING STRUCTURE ONLY
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Email *
Last Name *
First Name *
Student Grade Level *
Required
Address *
City *
State *
Zip Code *
Telephone Number *
Driver's License Number *
Driver's License Exp. Date *
MM
/
DD
/
YYYY
Vehicle #1 - Make, Model, Year, and Color *
Vehicle #1 - License Plate # *
Vehicle #2 - Make, Model, Year, and Color,
Vehicle #2 - License Plate #
We certify that the above information is correct and that the above student has a valid Driver's License or Interim Driver's License and applicable auto insurance. We have also read and understand the Issuing of Parking Permits, and Parking Lot Rules and Regulations page and agree to abide by these regulations and policies. *
Student Signature *
Parent Signature *
PAYMENT:  Please select the payment option below
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