COLLEGE OF WILLIAM & MARY PARKING REGISTRATION FORM (Resident) 2015-2016
Office of Parking Services
201 Ukrop Way
P. O. Box 8795
Williamsburg, Virginia 23187-8795
757 221-4764 FAX 757 221-4625
STUDENT ID CARD #
LAST NAME
FIRST NAME
CS BOX
BUILDING
ROOM NUMBER
CAMPUS TELEPHONE #
ALTERNATE TELEPHONE #
Affix
Barcode
Sticker(s)
Here
HOME ADDRESS
The information on this form is both true and accurate. I agree to notify Parking Services if and when any information
changes. Rules & Regulations may be accessed at http://www.wm.edu/parking. I have read and agree to abide by the
Rules & Regulations. Any outstanding tickets must be paid in full before purchasing a decal. I understand that obtaining
or displaying a decal under false pretenses is an HONOR CODE violation.
SIGNATURE: ______________________________________________
DATE ________________________________
Select Your Resident Student Status
GRADUATE
SENIOR
JUNIOR
SOPHOMORE
FRESHMAN
Select Your Decal Option
Handicap Tag
GRAD COMPLEX ($361)
RESIDENT STUDENT ($361) includes OTP & Tribe Square
STATE ADA PLACARD #
RESTRICTED USE (Freshmen & Sophomores w/Approved Exception
to policy) ($361)
CWM TEMP ADA PERMIT#
MOTORCYCLE ($181)
ISSUE DATE
LONG TERM STORAGE AT SOE Lot 3 (50%)($181) – does not
allow parking on main campus or VIMS campus
EXPIRATION DATE
Select Your Payment Method:
W&M EXPRESS #
MC/VISA/AMX/DISC #
EXPIRATION DATE (MM/YY):
CASH
CHECK
CHECK #
l Make check payable to The College of William and Mary
Pell Grant/Gateway Price (You must have financial aid award form at the time of purchase) 50% REDUCTION
PLEASE COMPLETE YOUR VEHICLE INFORMATION. ONLY ONE VEHICLE MAY BE REGISTERED TO A RESIDENT
DECAL. YOU MUST CONTACT THIS OFFICE TO CHANGE CARS DURING THE ACADEMIC YEAR.
VEHICLE INFORMATION
LICENSE PLATE #
STATE
VEHICLE MAKE
COLOR
YEAR
2 Door
3 Door (hatchback)
Truck
Sport Utility Vehicle
BODY STYLE
4 Door
Van
Station Wagon
Convertible
Motorcycle