Parking Permit Registration

Parking Permit Registration
Student Information
Student's Name *

First Name Last Name
School ID Number *
Driver's License ID Number *
Student's Permit Number
Paid

Yes No

Vehicle 1 Information
Year (Veh 1) *
Make (Veh 1) *
Model (Veh 1) *
Color (Veh 1) *
License Plate Number (Veh 1) *
Registered Owner Information
Owner's Name (Veh 1) *

First Name Last Name
Owner's Phone Number (Veh 1) *

Area Code Phone Number
Relationship to Driver (Veh 1) *
Insurance Information
Insurance Company Name (Veh 1) *
Insurance Policy Number (Veh 1) *
Do you have a second vehicle to add? *

Yes No

Vehicle 2 Information
Year (Veh 2)
Make (Veh 2)
Model (Veh 2)
Color (Veh 2)
License Plate Number (Veh 2)
Registered Owner Information
Owner's Name (Veh 2)

First Name Last Name
Owner's Phone Number (Veh 2)

Area Code Phone Number
Relationship to Driver (Veh 2)
Insurance Information
Insurance Company Name (Veh 2)
Insurance Policy Number (Veh 2)
Do you have a third vehicle to add?

Yes No

Vehicle 3 Information
Year (Veh 3)
Make (Veh 3)
Model (Veh 3)
Color (Veh 3)
License Plate Number (Veh 3)
Registered Owner Information
Owner's Name (Veh 3)

First Name Last Name
Owner's Phone Number (Veh 3)

Area Code Phone Number
Relationship to Driver (Veh 3)
Insurance Information
Insurance Company Name (Veh 3)
Insurance Policy Number (Veh 3)

Payment Options
How would you like to pay? *

Cash/Check Paypal/Credit Card
Please bring your cash or check to the Hopewell High School main office. The staff will confirm you have completed the form and will issue you a parking pass.
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Parking Permit $ 25.00

Total $ 0.00
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