Vehicle Registration Form

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All students that live on campus must register their vehicle with Campus Safety.

First Name *

Last Name *

Cell #

E-mail Address

Residence Hall *

North Suite #

South Suite #

120 A

120 B

121 A

121 B

123

125

130 A

130 B

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131 B

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134 B

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135 B

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138 B

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139 B

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239 B

301 A

301 B

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334 B

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335 B

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338 B

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339 B

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Vehicle Color *

What is your vehicle's make? *

What model is your vehicle? (Ex-Civic, Wrangler, Focus, Escape, etc.) *

What state (or country) is your vehicle registered in? *

What year was your vehicle made? *

What is your license plate #? *

What is your vehicle's VIN?

I agree to abide by the Cleary University rules for parking on campus. *

Yes

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