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Concord Academy

Student Parking Permit Request Form

STUDENT PARKING PERMIT REQUEST FORM

Parking Permits for 2017-18 will be issued during the first week of classes. Families are asked to complete this form and return to the Operations Department by August 7, 2017 (either by mail or by email to: sarah_woods@concordacademy.org). If your child anticipates receiving a license during the academic year, this form can be filled out at that time.

STUDENT NAME________________________________________ GRADE______________

HOMETOWN__________________________________ DATE OF BIRTH________________

VEHICLE MAKE______________ MODEL_____________ YEAR_______ COLOR________

PLATE #________________________

 

We have read both this form and the parking policy letter and agree to all conditions. We understand that failure to abide by these policies may result in suspension of the parking permit and thus one’s ability to drive to school as well as the possibility of a disciplinary response.

PARENT SIGNATURE_______________________________________ DATE________ CELL #_________________

STUDENT SIGNATURE______________________________________ DATE________ CELL #_________________

 

FOR ADMINISTRATIVE USE ONLY

Date Form Received:_______________________________

Student ID #:_____________________________________

Parking Permit #:__________________________________

Date of Issue:_____________________________________