Application For Automobile Driving Privilege

With increasing numbers of students driving to school and with buildings located near UPJ and Pennsylvania Highlands Community College, it has become necessary to register cars and motorcycles for parking privileges.

Please complete the application below to be considered for driving to Richland High School.

Name of Operator*
First Last
Email*
Grade*
School Year*
Address*
Street Address City State ZIP Code
Home Phone*
VEHICLE INFORMATION
Make of Car #1*
Year*
Color*
License Plate Number*
Insurance Company & Policy #*
Make of Car #2
Year
Color
License Plate Number
Reason for need to drive to school*
Student Driving Regulation Acknowledgement*
- I HAVE read and understand the Student Driving Regulation Acknowledgement
- I HAVE NOT read or understand the Student Driving Regulation Acknowledgement
Date*
Student Signature*
Parent/Guardian Name*
First Last
Parent/Guardian Signature*

Application For Automobile Driving Privilege

VEHICLE INFORMATION