Registration Type
|
|
Personal Information
|
| Last Name: |
|
|
First Name: |
|
| Middle Initial: |
|
|
Winthrop University Id #: |
|
| Date of Birth: |
|
|
Cell Phone #: |
|
| Driver's License #: |
|
|
State of Issue: |
|
| Email Address: |
|
|
Gender: |
|
| |
Local Address
|
| Residence Hall: |
|
|
Residence Hall Room #: |
|
| Address (Name & Number): |
|
|
City: |
|
| State: |
|
|
Zip Code: |
|
| Home Phone #: |
|
|
|
|
| |
Permanent Address
|
| Address (Name & Number): |
|
|
City: |
|
| State: |
|
|
Zip Code: |
|
| Home Phone #: |
|
| |
Current Bicycle Information
Locate the Serial Number for your Bicycle (pdf - 2.04 MB)
|
| Make: |
|
|
Model: |
|
| Serial #: |
|
|
Color: |
|
| Category: |
|
| Miscellaneous Description: |
|
| |
Prior Property Registration (If Applicable)
|
| Municipality: |
|
|
State: |
|
| Decal or Engraved Number: |
|
|
Expiration Date: |
|
| |
| |