2009-2010 Student Vehicle Registration Form

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2009-2010 Student Vehicle Registration Form Powered By Docstoc
					                                 2009-2010 Student Vehicle Registration Form
                                All motor vehicles parked on University property or on adjacent city streets must be registered with the Office of
                                Safety and Security in order to comply with Seattle City Regulations. Registration is free; however a permit must be
                                purchased to use the Commuter or Resident Hall parking lots. Anyone operating a motor vehicle on campus is
                                expected to be familiar with the parking regulations, available in the Security Office or on-line at
                                 If you need to cancel your parking, you must return your decal and notify the Security Office in writing. You
                                     must notify Security within 10 days if you change vehicles or leave SPU
                                 Commuter lots are enforced Monday through Friday from 7 am to 4 pm. Other lots and areas are enforced

                                  Personal Information (*Please send address changes to University                           Special Considerations
 You will automatically
 be enrolled in parking           Services.)
 for each quarter you                     ID# (SSN)                                                                          Check all that Apply:
 select                                                                                                                      □ Handicap
 □ Fall                                       Name                                                                           □ PA (Peer Advisor)
 □ Winter                                  Phone #                                                                           □ Evening Student
                                                                                                                             □ ACELI Student
 □ Spring                                     E-mail
                                                                                                                             □ Fuel Efficient Vehicle

Parking Choice                                                                                               Parking Fees
 □ Commuter Lot                                                                                              Street........................Free
 □ Street Parking: Does not authorize use of Commuter Lots, except between                                   Commuter……........$57.00 per qtr
     4:00pm & 7:00am                                                                                         Resident……….......$57.00 per qtr
 □ Carpool (for Commuters only): List the names of the individuals you will be                               Emerson Resident....$77.00 per qtr
     carpooling with.                                                                                        EME +Motorcycle…$40.00 per Qtr
                                                                                                             2nd Vehicle Decal….$7.00 per Qtr
      Name                                                                                                   Replacement Decal…$5.00
      Name                                                                                                   2 Person Carpool.....$28.50 per Qtr
                                                                                                             3+ Person Carpool...Free
   Name                                                                                                      Motorcycle only…...$28.50 per Qtr
 □ Residence Hall, Theme, Graduate, Family
   Housing or Campus Apartment (write in):                                                                   To cancel parking and receive a
    Please choose one of the following in case                        □ Commuter □ Street                   full refund, you must notify
     your first choice is full.                                                                              Security in writing, and return
                                                                                                             your decal within the first 10 days
    Would you like to be added to the Waitlist, if                        □ Yes □ No
                                                                                                             of the quarter. Refunds will be
     your first choice is full?
                                                                                                             pro-rated after that.

Vehicle Information    □ I drive a motorcycle.
 Vehicle 1                                                                    Vehicle 2
                  License                                                                               License
  State                                                                        State
                  Plate #                                                                               Plate #
  Make                                                                         Make
   Model                                                                       Model
   Year                       Color                                            Year                         Year

   Size (circle                                                                Size (circle
                        Sub-compact           Compact           Midsize                             Sub-compact           Compact      Midsize
   one)                                                                        one)

                  SUV         Mini-van            Full      Extended                          SUV         Mini-van           Full    Extended

                                                                                      Office Use Only
By signing this form, I agree that I have read it and that I fully understand it. I
further agree to abide by the written parking regulations and to pay all
appropriate parking fees and/or fines.

 Signature                                               Date
                                                                                        Received By               Date Entered            Initials