Parking Permit Request (10th-12th grades)
Filling out this form does not guarantee that you will be issued a permit.   There are limited spaces available and they will be given out to full time scholars in descending order of grade. In obtaining this permit you will be required to follow all local driving laws and practice courteous driving in our parking lot.  
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Email *
I am currently a: *
I understand that I cannot remain in in my vehicle before school, during lunch, or after school. *
I understand that I cannot leave in my vehicle during the lunch periods unless I am a part time student leaving campus or I am a senior with permission to leave. *
I understand that I may use my vehicle as a locker/storage but cannot remain in my vehicle. *
I understand that there will be no reckless driving. (Faculty will determine what is and is not reckless driving) *
I understand that I will always give the right of way to pedestrians. *
I understand that any damage resulting from the use of the parking lot is the responsibility of the driver. Heritage Academy has no liability for damage. *
SCHOLAR LAST NAME *
SCHOLAR FIRST NAME *
VEHICLE MAKE (i.e. Ford, Toyota, etc. *
VEHICLE MODEL (i.e. Explorer, Prius, etc. *
VEHICLE YEAR *
VEHICLE COLOR *
LICENSE PLATE NUMBER *
By checking yes on this form, I understand that violation of any of these guidelines will result in the termination of my parking privileges. *
Driver's License Number *
Expiration Date of Driver's License *
MM
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DD
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YYYY
Issuing state of Driver's License *
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