Form: SCCC0009 Rev. 2/2019
All motor vehicles parked on SUNY Schenectady County Community College campus grounds and remote parking lots by
students, faculty or staff (full and part-time) must be registered with Campus Security and have the appropriate hang tag
displayed from the rear view mirror.
Failure to register your vehicle or properly displaying your College hang tag will result in the ticketing and/or towing of
your vehicle (at owner’s expense).
Please bring your Student Identification Card along with this completed form to the Security Office in Elston Hall,
Room 341 to receive your new hang tag.
1. Personal Information: (Please Print Clearly)
2. Vehicle Information:
License Plate #
Hang Tag #
Tickets are issued for violations of parking regulations. An appeal of a parking ticket must be forwarded in writing to the
Director of Campus Safety within five (5) class days of when the ticket was issued; the appeal should include a copy of
the ticket and the reason(s) the student believes the ticket is invalid. The student will receive a written response via the
email address provided on the appeal form regarding the disposition of the appeal within five (5) class days of when the
appeal was received.
3. Req
uester’s Signature ___________________________________________________ Date _____________________
4. Is
suing Official’s Signature: _______________________________________________ Date _____________________
Last Name First Name Middle Initial
Student ID# Emergency Contact Number (cell phone)
For Administrative use only