Parking Permit Application

 Grade:

Semester ___________________________

Student Name Student Number

Verified GPA____________________________________________________________

Counselor/ Administrator Signature

I understand I am purchasing an assigned parking space in the Burbank High School Parking Structure Student Level and agree to park in only my assigned space. I am parking at my own risk and understand that Burbank High is not responsible for theft or damage to my car.

Student Signature

Date

Parent Signature

Date

Assigned Space#

Description of Car

Make_______________________________________________

Model______________________________________________

Color_______________________________________________

License_____________________________________________