Faculty/Staff Parking Registration Form

Department Contact

1600 Harden Street
Columbia, SC 29204

803-253-5000

Office Hours 9:00AM - 5:00PM

Driver's Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home/Cell Phone*
Vehicle Make/Model*
Vehicle Color*
How many doors?*
License Plate Number*
License Plate State*
Upload copy of Benedict College ID, Driver's License, Registration, and Proof of Insurance*
Drop files here or

Accepted file types: pdf, jpg, png.
File must be a pdf, jpg, png
Faculty/Staff Parking Decal Fee*
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
Signature*