| STUDENT VEHICLE REGISTRATION FORM | ||
| Registration No:_________ | ||
| DRIVER'S NAME:______________________________________________________ | ||
| VEHICLE LICENSE NUMBER:_________________________________________ | ||
| VEHICLE MAKE / MODEL:____________________________________________ | ||
| VEHICLE COLOR:______________________________ | ||
| Name of Insurance Company;_________________________________________ | ||
| Policy Number:________________________________ | ||
| Driver License Number: ____________________________ | ||
| The following students are permitted to be transported by the above named student. | ||
| NAME | DOCUMENT ON FILE | |
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| PARENT SIGNATURE:________________________________________________________ | ||
| ADMINISTRATIVE SIGNATURE:________________________________________________ | ||
| DATE:________________________________ | ||
| ALL vehicles MUST be registered in the office and a driving pass obtained to be displayed on the rear | ||
| view mirror. Violation of driving policy will be subject to driving priviledge suspension. Driving priviledges | ||
| will be suspended for such misconducts as, but not limited to: | ||
| a. Reckless driving in parking lot | ||
| b. Illegally passing school bus | ||
| c. More than three (3) tardies to school | ||
| d. Suspensions from school | ||
| e. Loitering or visiting in the parking lot | ||
| ACTION: | ||
| First offense: Thirty (30)school days loss of driving priviledge | ||
| Second offense: Sixty (60)school days loss of driving priviledge | ||
| Third offense: Ninety (90)school days loss of driving priviledge | ||
| Fourth offense: One (180) school days loss of driving priviledge | ||
| Any student driving to school and found to be in possession of a controlled substance, drug | ||
| paraphernalia, tobacco products or leaves school without permission in his/her vehicle will | ||
| have driving priviledges removed for one year commencing with the date of the infraction. | ||
| I have read the driving policy and understand that my privilege to drive may be withdrawn | ||
| if I fail to follow the policy. | ||
| Student Signature:___________________________________________________________ | ||
| Please be advised student driver's license will be checked periodically. | ||