SIENA HEIGHTS UNIVERSITY SAFETY AWARENESS HANDBOOK
FORMS
Parking permit application , please tear out , complete and return to Public Safety .
Department of Public Safety Siena Heights University 517-264-7800 www . SienaHeights . edu / CampusSafety
PARKING PERMIT APPLICATION
Complete in Full & Return to the Department of Public Safety with Payment
Permit Type , Circle Choice : |
Resident |
Commuter |
Campus Village / |
Faculty / Staff |
Dual Enrolled |
|
|
|
Saint Catherine Hall |
( No Charge 1st / Non-Expiring ) |
|
Permit Period , Circle Choice : |
Annual |
Fall Only |
Winter Only |
Summer Only |
2 nd Vehicle |
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|
|
|
|
$ 5 ( Same Period as 1st ) |
Name : Date of Birth : ___/___/___ ( optional )
First Middle Last MM / DD / YY
Home Address :
House # & Street / Apartment City State Zip Code
On Campus Room / Office Number : ___________________ Phone Number : SHU ID #: Drivers Lic #: State : Plate : State : Make : Model : Year : Color :
I agree to abide by all Siena Heights University parking rules and regulations . Date : ___/___/___
Signature
Parking Rules and Regulations can be found in the Safety Awareness Handbook and online at www . SienaHeights . edu / parking
For Department of Public Safety Use For Department of Public Safety Use For Department of Public Safety Use
Permit #: Received : ___/___/___ By : Entered : ___/___/___ By : Method of Payment : Cash Check #: _____________________