Tuesday, December 01, 2015
  Employee Vehicle Registration Form
Police Department
**  Required Fields.  
First Name **   Last Name **
Employee ID **
  E-Mail Address **

Home Address **   City **
State **   Zip Code **
Home Phone **
(nnn) nnn-nnnn
  Office Phone **
(nnn) nnn-nnnn

License Plate **   State **
Style **   Color **
Make of Vehicle **   Year of Vehicle **

Are you the registered owner?     If not, provide owner's name  

Employee Type      
Department   Title / Position

Is this form replacing a previous registration form?  
Previous Decal Number or Vehicle Description  

I agree to abide by the rules and regulations governing the use of motor vehicles on the Monmouth University campus
as set forth in the Parking & Traffic brochure. I understand that Monmouth University is in no way liable for personal
injury, damage, or loss of parts or contents of vehicles.