Student Parking Pass Request

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Students -  Parking Permit Request

Student ID Number*(The Student ID number issued to you upon registering with Alamance Community College)

First Name

Last Name*

Phone*

License Plate Number (if requesting parking permit)Please enter the license plate of the primary vehicle being driven.

Curriculum/Program of StudyExamples: University Transfer, Biotechnology, GED, etc.

How would you prefer to receive your tags?*

Pick up at Main Campus Information Desk

Pick up at Dillingham Campus Front Desk

Mail to me (enter address below)

If you choose to have your tags mailed, enter the mailing address hereIt is your responsibility to enter the correct mailing address

Email*We will utilize this method to inform you of your request completion. By providing your email you give the Department of Public Safety at Alamance Community College authorization/permission to communicate/contact you by this method. Should you decide you do not want to provide your email, you may contact the Public Safety by calling 336-506-4286 to set up an appointment.

Date submitted*

Form UUID Site Name

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