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Student Name:*
Student PSU email:*
PSU ID Number:

PSU ID Number is the bottom number on the front of your Penn State ID Card
Local Address:
City, State, Zip Code:

Vehicle Information
Make of Vehicle:
License Plate Number:
  By checking this box, I agree to the terms and conditions described in the parking regulations of the Pennsylvania State University, Brandywine campus and will abide by them and the laws set forth in the Vehicle Code of Pennsylvania.

Make of Vehicle: Ford (example)
Model of Vehicle: Mustang (example)