VEHICLE REGISTRATION FORM

Please use this form to register your vehicle wth the Tusculum College Department of Campus Safety.

Required fields are marked with a red asterisk: *

Vehicle Registration Information
Today's Date:

Your Name: *
I am a: *

Please enter information about the vehicle you are registering.

Manufacturer: *
Model: *
Color: *
Year: *
Registered to: *

Please enter your license plate information.

License plate number: *
State: *
Expiration Month/Year: / *

Please enter your valid driver's license information.

Driver's License number: *
State: *
Expiration Month/Year: / *

Please verify that you have Car Insurance.

Yes, I verify I have car insurance.

For students, please enter the following:

Student ID: *
Student Type: GPS Student Resident Commuter*

Location:

Residence Hall:
Room Number:

For employees, please enter the following:

Location:
Department:
Building:
Office No.:
Campus Phone/Extension:

For the privilege of utilizing the roadways and parking areas of Tusculum College, the user agrees to abide by the rules and regulations formulated in order to best utilize resources for the benefit of the Tusculum College community, including students, faculty, staff, guests, vendors and visitors. Those rules and regulations can be found in the Tusculum College Motor Vehicle Rules and Regulations Handbook

I have read the above information and have provided the information requested, and fully agree to these conditions.
Your Name: *