NMMI Employee Vehicle Registration Form
First Name: Last Name: Middle Initial:
ome Address: Home Phone:
ity: State: Zip Code:
ork Area: Work Phone:
icense Plate #: Lic. Plate State: Make: Model:
Year: Body Style: Color:
certify the information given on this application is true and correct. I agree to familiarize myself with
the NMMI Traffic Regulations and operate my vehicle accordingly.
NMMI assumes no responsibility for damage or loss to any vehicle operated or parked on campus.
Please print and sign the form. Take the completed form, along with a copy of the below listed
documents to the Cashiers office in Lusk Hall:
•Vehicle Registration (State Issued registration)
•Proof of insurance
The fee for registering a vehicle with the NMMI PD is 2.00 dollars, payable at the Cashiers Office.
NMMI Campus Police
For Campus Police Use Only: