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Get Moline High School Parking Tag Form

For office use only Parking Tag Date Moline High School Parking Tag 20. 00 This form must be completely filled out and signed student must physically show driver s license and pay 20. All incidents described above should be reported to the Moline Police Department and Moline High School Student Affairs Office. I understand the above guidelines in regards to obtaining a Student Parking Tag. Signature of Student Signature of Parent mandatory for student under the age of 18. 00 plus any outstanding fees and fines must be paid prior to receiving a Parking Tag PLEASE PRINT CLEARLY Student Name Address Phone Number Year of Car Make Model Color of Car License Plate Is license plate Permanent or Temporary check one If plates are temporary you must report permanent plate to the Bookstore within 30 days. Driver s License All outstanding fees and fines must be paid in order to purchase a Parking Tag. Replacement cost for any lost or stolen Parking Tag is the same as purchase price. There are no prorated replacement and/or discounted prices. Parking privileges are contingent on acceptable attendance academic and behavioral performance. Failure to maintain acceptable standards may result in a loss of parking privileges. All students must hang their parking tag from the rearview mirror at all times. Failure to display their parking tag or students who park in non-designated areas will receive a parking ticket. All tickets must be paid to the Moline Police Department. DISCLAIMER Students and parents should understand that Moline School District No* 40 assumes no responsibility for damages to said car while parked on school grounds. Damages could include actions by vandals theft to the car including contents inside the vehicle accidents and acts of God. All incidents described above should be reported to the Moline Police Department and Moline High School Student Affairs Office. I understand the above guidelines in regards to obtaining a Student Parking Tag. Signature of Student Signature of Parent mandatory for student under the age of 18. 00 plus any outstanding fees and fines must be paid prior to receiving a Parking Tag PLEASE PRINT CLEARLY Student Name Address Phone Number Year of Car Make Model Color of Car License Plate Is license plate Permanent or Temporary check one If plates are temporary you must report permanent plate to the Bookstore within 30 days. Driver s License All outstanding fees and fines must be paid in order to purchase a Parking Tag. Replacement cost for any lost or stolen Parking Tag is the same as purchase price. Driver s License All outstanding fees and fines must be paid in order to purchase a Parking Tag. Replacement cost for any lost or stolen Parking Tag is the same as purchase price. There are no prorated replacement and/or discounted prices. Parking privileges are contingent on acceptable attendance academic and behavioral performance. There are no prorated replacement and/or discounted prices. Parking privileges are contingent on acceptable attendance academic and behavioral performance. Failure to maintain acceptable standards may result in a loss of parking privileges. All students must hang their parking tag from the rearview mirror at all times.

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