D’Evelyn Parking Application Form
2018-2019 School Year - Fee $125 for the year, prorated $12.50 month after August
I agree to the terms and responsibilities stated below and on the back of this document in connection with obtaining authorization to use the school parking lot.

I understand that the parking lot is the property of Jefferson County Public Schools R-1. I agree that the car driven will not be used to transport or store illegal items on school property. I agree that I will not use the school parking lot to violate a criminal code or school rule.

In exchange for the privilege of parking on school property, I give school officials and/or school security personnel consent to search the car and the car’s contents at any time when it is parked on school property.

I authorize school officials and/or school security personnel to seize any item that violates a criminal law or school rule or provides evidence of a criminal law or school rule violation.

I understand that violations of these rules and/or the site based rules on the back of this document can lead to suspension or revocation of my parking privileges, fines, referral to law enforcement authorities and/or school disciplinary actions.

Site Based Rules and Expectations

1. All vehicles driven to school must be registered with the school and the student parking permit must be displayed in a location clearly visible from the outside of the vehicle.

2. Speed limit on school grounds is 10 MPH. The vehicle must be operated in a safe and legal manner at all times.

3. School parking permits are valid from 7:30 a.m. to 2:30 p.m. and are limited to the (spaces delegated to students including any reserved spaces or off-limits spaces)

4. Students are not allowed to loiter in the parking lots or vehicles before, during, or after school hours.

5. Parking in fire lanes, no parking zones and/or restricted areas is prohibited.

6. Violations of rules and expectations may lead to fines, parking boot, or towing as well as law enforcement involvement and school disciplinary consequences.

7. All students who drive to school must purchase a parking tag and students must park in the student lot on the west side, not on the side streets or surrounding areas.

Fines

$20.00 - Parking in a fire lane or a disabled spot (Ticket from law enforcement and possible towing of car is also possible)

$5.00 - Replace lost parking permit

$20.00 - Parking in areas not open to students (staff or visitor parking, restricted lots, etc.)

$20.00 - Non-registered vehicle on school grounds

$10.00 - Not displaying parking tag

$20.00 - Underclassmen, parking in senior spots marked “S” or parking in reserved spots

$20.00 - Altering, falsifying, transferring without permission a parking tag and possible suspension and/or revocation of parking privileges.

$30.00 - Operating a vehicle in a dangerous or reckless manner on school grounds or in the immediate neighborhood and possible suspension and/or revocation of parking privileges.

Students have 10 school days to dispute or contest any fines. All fines should be paid within 30 days and it is the student’s responsibility to communicate with parents regarding fines.

*
Required
Student’s Last Name *
Your answer
Student's First Name *
Your answer
Grade *
Vehicle 1
Vehicle Make (Ford, Nissan, Etc.)
Your answer
Vehicle Model (Edge, Rogue, Etc) *
Your answer
Color *
Your answer
License Plate Number *
Your answer
Vehicle 2
Vehicle Make (Ford, Nissan, Etc.)
Your answer
Vehicle Model (Edge, Rogue, Etc)
Your answer
Color
Your answer
License Plate Number
Your answer
I (enter student's name below) understand and agree to the above terms. *
Your answer
I (enter parent's name below) understand and agree to the above terms. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Public Schools. Report Abuse - Terms of Service - Additional Terms