VEHICLE REGISTRATION INFORMATION CHANGE FORM
This form should be completed if you have any changes in information. This includes name and vehicle changes from the previous year registration. Failure to provide current information could result in suspension of the current parking PLEASE PRINT OR TYPE
Personal Information
Name: ___ Student ID#: ___ Last First
Name
Student ID
Campus Address:
Campus Address
Building and room number
Home Address: ___ City State Zip
Home Address
Telephone #:___ Driver License:___ State Vehicle Information Primary Vehicle
Telephone
Driver License
License Plate: _____ State: _____
License Plate
State
Handicap #:_____ State: _____
Handicap
State
Year: ___ Make: ___ Model: ___ Color: ___
Color
Year
Make
Model
Secondary Vehicle
License Plate: ___ State: ___
License Plate
State
Handicap #:_____ State: _____
Handicap
State
Year: ___ Make: ___ Model: ___ Color: ___
Color
Make
Year
Model
Owner Information
Name: ___ Last First Home Address: ___ City State Zip Permit #: ___ 7/21/2011
Name
Home Address
Permit