Student's First Name
Student's Last Name
Home Phone (xxx-xxx-xxxx)
Cell Phone (xxx-xxx-xxxx)
Driver License No.
Driver License Issue State
The vehicle described above is legally registered in my (or my mother's or father's) name. It
is my responsibility to read and be familiar with the Transy campus traffic regulations. I
realize that I am subject to loss of campus driving/parking privileges and disciplinary action
if I have reported any false or erroneous information above, and that registration of my
vehicle and payment of any required registration fee does not guarantee me parking space
on campus or any specific location.
I accept the above terms.
To pay online with electronic check or credit card click here.
To pay via check, mail $30.00 payment to:
Department of Public Safety
300 N. Broadway
Lexington, KY 40508
Make check payable to Transylvania University.
Please include student's name on memo line of check.