2023-2024 INDIAN RIVER HS Parking Pass Application
This application is for registering a vehicle by Junior and Senior students enrolled at Indian River High School for the purpose of securing a parking decal.

Rules and regulations pertaining to on-campus parking and operation of a vehicle are contained herein. Completion of this application shall be construed as acceptance of the parking and operation rules and regulations. Students who elect to drive a vehicle shall complete this application form. Information regarding the sales of permits is included at the conclusion of the form.  

Students who are not able to obtain a parking permit prior to opening day should not drive to school.  These students should see a security monitor to process their application on the first day.  Students must have a parking permit PRIOR to parking on school property.  Parking permits will be sold until the predetermined supply is exhausted.
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Student Name *
Last Name, First Name
Student Grade Level *
Choose one
Student Number *
Student's Home Address *
Street Address - Only specify your city if you do not live in Chesapeake, VA
Student Phone Number *
Parent/Guardian Information:
Required information below must be accurate and complete to secure a student parking permit.  
Parent/Guardian 1 Name: *
Parent/Guardian 1 Phone primary phone or cell number: *
Parent 1/guardian work phone number:
Parent/Guardian 2 Name:
Parent/Guardian 2 primary or cell number: *
Parent/Guardian 2 work number:
Car Information - Vehicle #1
Please provide us with the make and model of the automobile the student will drive to school.
Car Make *
Example: Ford Fusion
Car Color *
Year the Car was made *
ex: 2005
License Plate *
Car Information - Vehicle #2
Please provide us with the make and model of any additional automobiles the student will drive to school. Please note: If a student needs to register a second vehicle, there is an additional $25.00 cash fee. (all parking permits are $25)
Car Make
Example: Ford Fusion
Car Color
Year the Car was made
ex: 2005
License Plate
Please remember to bring the following to school when you purchase your parking permit:
1. Completed and Signed Parking Permit Agreement  Parking Permit Application  
2. A valid Drivers' License (for verification purposes)
3. CASH Payment ($25 for each pass), Check, or Receipt from Online School Payments.


Also...you must have submitted this form before purchasing a permit!
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