2022-23 Parking Tag Application
Process

1. Fill out the following form as completely and accurately as possible. 

2. Go see Mrs. Kline - check in at Security.
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Email *
By filling out this electronic form, I (student named below) 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 by me 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 driven by me 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.

Student Last Name *
Student First Name *
Grade *
Date of Birth *
Ex: 01/01/1990
Address *
City *
State *
Zip Code *
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