LEV Preferred Parking Application for SUNY-Erie Community College APROVED _______
DENIED ______
SECURITY USE ONLY TAG NUMBER: ________________ Name: Email (Important!): _____________________________________________ Employee or Student (circle one) ID Number: Vehicle Year (e.g. 2016): Vehicle Make (e.g. Honda): Vehicle Model (e.g. Accord): License Plate Number: _______________________________________________ Vehicle Specification (e.g. 2.0L/4/auto – Engine/Cylinder/Transmission): Important! Provide as much information as you can: _______________ I certify that the above information is true and correct. I agree to use the LEV Hang Tag only on the vehicle that was described above. Signature:
Date:
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Take the completed form, vehicle registration and your photo ID to the Security Office to receive the LEV Hang Tag. The LEV Hang Tag is to be hung on the rearview mirror at the front windshield. Inform the Facilities and Operations Department if you purchase a different vehicle.
REASON FOR DENIAL: □ VEHICLE NOT ON LIST □ INSUFFICIENT VEHICLE INFORMATION PROVIDED □ OTHER: _____________________________________