Application For a Freshmen Automobile Permit

University policy prohibits residential freshmen students from having an automobile on campus.  However, three exceptions to this policy are ordinarily recognized.  To apply for an exemption to the Freshmen Automobile Policy, please complete the following form.  All fields are required to complete your application.

Name

Campus Address

Local Phone Number

Home Address

Home Phone

Your Email

Please check all that you believe to qualify you for an exception to this policy.

Excessive Distance (500 or more miles from home)
Off-Campus Employment with Valparaiso area employer (Attach a letter from your employer, on their business letterhead, verifying your employment)
Medical (Attach a letter from your physician, on his/her letterhead, verifying the student's condition that necessitates on-going appointments and a statement of why these appointments cannot be scheduled around University vacation periods.)

Upload documentation here (if required):
I have read and understand all of the above information.