Parking Tag
If you have any questions, email Chief Pierre at Mpierre@uhcno.edu
Name
*
First Name
Last Name
Student ID number:
*
Driver's License Number:
*
Student Email
*
example@example.com
Personal Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Name of Registered owner
*
Registered Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Year of vehicle
*
Make / Model
*
2 or 4 door
*
Color
*
Plate number
*
Expiration of plate #
*
Copy of Insurance Card
*
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Parking Tag
$
20.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: