Parking Registration Form

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Book Navigation Home Student Life Safety, Security & Parking Parking Vehicle Registration Parking Registration Form

Date:

Select Date

First Name:

Last Name:

Middle Initial:

Student I.D. Number:

Email:

Permanent Address:

City:

State:

Zip Code:

Home Phone:

Local Phone:

Local Address:

Resident Hall Occupant?
YesNo

Please choose permit type:

License Plate Number:

Make:

Model:

State:

I agree to comply with the university parking and traffic regulations as published, and have received a copy. (Refer to parking and traffic regulations for detailed information.) I also understand that I am fully responsible for my vehicle while it is on the BHSU campus.

I AgreeI Disagree

Payment: