ISU-PI-D-024-005
I-SHOU UNIVERSITY
Application Form for Reissuance of Motorcycle Parking Access Card for Students
Applicant
Class
Student No.
Name
Motorcycle
Model
Motorcycle Plate
No.
Pass No.
Contact No.
Reasons for Application
I, the undersigned, □ lost my parking access card □ had my parking access card damaged, and hereby apply to the
University for reissuance and pay the application fee of NT$100. I shall be held liable if found to have lent the parking
access card to another person.
Applicant:
Safety Section
Cashier Section
Ratification
Affidavit
I, the undersigned, shall be held liable if found to have lent the parking access card to another person, thus leading to
damage on other students’ rights and interests.
Applicant:
Date:
/
/
(yyyy/mm/dd)