APPLICATION FOR
STUDENT HOUSING PARKING
Within Reach. Beyond Imagination.
1 888 953 1133 selkirk.ca
Last Name: First Name: Assigned to Room Number:
Area Code: ( ) Phone Number: Email(s) most used:
Address: City/Province: Postal Code:
Student Housing Coordinator: Decal Number:
Vehicle Colour: Vehicle Make/Model:
Vehicle Year: License Number:
Date of Birth (dd/mm/yy): Student ID Number: Program of Study:
If you wish to apply for Student Housing Parking please return the completed application form along with your Student Housing fees. Upon check-in your
parking decal will be given to you. Place decal in lower corner of glass on front of vehicle.
• Vehicles parking in Fire Lanes will be towed at owner’s risk.
• Vehicles not displaying decals may be towed at owner’s risk.
• Residents may not park a vehicle in the Student Housing parking lot that is losing excessive uids.
• Residents will be charged for damages resulting from a residents vehicle losing uids such as gas, oil and transmission uid.
• Residents are not permitted to park vehicles in the Student Housing parking lot without valid vehicle insurance.
Stamp indicates approval
OFFICE USE ONLY
Date Signature
STUDENT
HOUSING
click to sign
signature
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