Fill - Free fillable Application for Parking Privileges (Eastern New Mexico University) PDF form

q Faculty/Staff q Student q Community member Forofcialuse:

qVisitor q Contractor Permitnumber:

Application Information

Full legal name:

Last First Middle

ENMU address (if any):

Dormitory Room number

Local physical address (if different):

Street City State ZIP

Where do you receive mail?

Street/PO box City State ZIP

Home phone: Work phone:

Mobile phone: Emergency phone:

ENMU ID: Birthdate:

State of registration: Year of vehicle: Make: Model:

Color: License plate no.: Driver’s license no.: D.L. state:

Vehicle identification number (VIN):

Registration expiration year: Vehicle style: (Example: 2-door car, 4-door car, SUV, pickup)

For official use only: Height: Weight: Hair color: Eye color:

Instructions

EachapplicantmustlloutthisforminordertoreceiveaparkingdecalortemporarypermitfromtheEasternNewMexico

UniversityDepartmentofPublicSafety(ENMUDPS).Thisformmustbecompletedentirelyandaccuratelybeforeanypermitor

decalwillbeissued.Inshort,itisthepolicyofENMUforeachandeverystudent,faculty,and/orstaffmembertohavehis/her

vehicle(s)registeredthroughtheENMUDPSwhichwillbeoperatedand/orparkedontheUniversityproperty.

Statement of Understanding and Agreement

IunderstandthatfailuretoproperlydisplayanENMUparkingdecalortemporarypermitonanyvehicle(s)operatedorparked

onENMUisaviolationofENMUParkingRegulations.IalsounderstandthatIwillobeyallstatelawsandENMUtrafcrules/

regulationsastheynowexistormayhereafterbeproperlycreatedbythestateorENMUadministration.Iunderstanditismy

responsibilitytobecomefamiliarwiththeENMUParkingRegulationsbrochurethatwasprovidedtomeatthetimeofthe

issuanceofmyparkingdecalortemporarypermit.Furthermore,mysignaturebelowreectsIunderstandthisisanofcialstate,

Universityandlawenforcementdocument.Intentionalfalsicationsofanyand/orallinformationormaterialfactcontainedon

thisformmaybegroundsforadministrativeorcriminalsanctionsandmaybegroundsforformaladjudicationproceduresfor

violation(s)oftheENMUStudentCodeofConduct.

Signature:

Date:

Forofficialuse:

PN1953•1/18

Application for Parking Privileges

Department of Public Safety | Phone: 575.562.2392

Department of Public Safety

**Bringdriver’slicenseandcurrentvehicleregistrationwhenturninginthisform**

ENMUDPSislocatedonthecornerof3rdStreetandSAveK

Fill Online, Printable, Fillable, Blank Application for Parking Privileges (Eastern New Mexico University) Form