Information and Permit Type

First  Name
Middle  Initial
Last  Name
Student  ID
Mailing  Address
City
State
Zip
Email  Address
Mobile  Phone
Text  Number  (if  different)


Session 1 June 21- July 23 R permit $108.00
Session 2 July 26 - Aug 27 R permit $108.00
8 Week Session June 21 - Aug 13 R Permit $180.00
10 Week Session June 21 - Aug 27 R Permit $213.00
Independent Field Studies June 21 - Aug 27 R Permit $213.00

Select  a  Permit  Type Ses._1Ses._28_week10_weekField Study
License  Plate  1
License  Plate  2
Method  of  Payment VisaMasterCardStudentBill
If no payment method is provided, your permit cost will be charged to your UCSC Student Account.
Please  enter  your  authorizing  signature
Would  you  like  this  permit  to  be  mailed  to  the  address  that  you  provided  above  ? yesno