Parking Fee Opt Out Form
Students who can prove that they do not use Palm Beach State College transportation facilities at any campus may
submit a Parking Fee Opt Out Form to any campus Dean of Student Services. The opt out form will be reviewed and, if
approved, the Parking Fee will be exempted from the student’s registration fees. Students with an exempted fee are not
eligible for a parking decal. Parking fines will be doubled for those who have an approved opt out form and are ticketed
for parking without a PBSC permit, regardless of vehicle ownership.
The Parking Fee includes, but is not limited to, the use of bus waiting areas, drop off points and bicycle
facilities. Lack of car ownership or driver’s license is not sufficient grounds to opt out.
The deadline for submitting the opt out form is the last day for 100% refund for credit classes (dates listed on the
registration calendar) and prior to the first class meeting for non-credit classes. Students must attach a copy of their class
schedule. A new opt out form must be filed each academic term before the deadlines mentioned above.
If you have questions, please contact your campus Dean of Student Services.
Date: Student ID#:
Student Name:
Last First M.I.
Address:
City:________________________________________________ State:_________ Zip:______________________
Phone Number:
Opt Out Requested for: Year: Semester (choose one): Fall Spring Summer
Reason for Opt Out:
I attest to the fact that the information stated above is true and complete.
Student Signature: Date:
Students who have a change in circumstances and need to obtain a parking permit after an opt out has
been approved should follow the procedure for obtaining a replacement parking decal and pay the
appropriate replacement fee.
Active Decal: □ Yes □ No
College Use Only
Date:
Decal # Campus Security Staff Signature
Appeal Granted:
□ Yes □ No Date:
Appropriate Signature
Exemption added by: Date:
Print Name
click to sign
signature
click to edit
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