VEHICLE REGISTRATION FORM
Name:
*
Last
First
Department
*
M1 - Class of 2024
Cell Phone:
*
Vehicle 1 :
*
Make and Model
Year
Color
License Plate # and State
Vehicle 2 :
Make and Model
Year
Color
License Plate # and State
Vehicle 3 :
Make and Model
Year
Color
License Plate # and State
Submit
**Information below will be completed by School of Medicine.**
Decal 1 :
Decal Color
Decal #
Date Issued
Decal 2 :
Decal Color
Decal #
Date Issued
Decal 3 :
Decal Color
Decal #
Date Issued
Should be Empty: