Vehicle Registration Information

"*" indicates required fields

Vehicle Tag #*

State*

Driver's Name*

Driver's Phone Number

Email Address*

Campus Address

Vehicle Owner's Name

Vehicle Owner's Address

Street Address Address Line 2 City State ZIP Code

Year of Vehicle

Make

Model

Color

Insurance Company's Name

Insurance Company's Address

Street Address Address Line 2 City State ZIP Code

Insurance Policy Number

Expiration Date*

Drivers License Number*

State of Issue*

Expiration Date*

I have read and understand the traffic regulations as written and enforced by the Department of Campus Safety and Security, and I agree to abide by them. I also understand that it is a privilege not a right to operate a vehicle on any property belonging to St. Andrews University, a branch of Webber International University, and that violation of these traffic regulations can result in the loss of said privilege. I acknowledge that by submitting this form, I am providing an electronic signature verifying that the information is correct as submitted and an accurate reflection of my consent as indicated above.