UNCW Bicycle Registration Form

Fill out this form and print it. Then bring it by the University Police Department to get your Registration Sticker
Last Name:
First Name:
Middle Name:
Date:
   
Student ID Number:
   
Local Phone Number:
Home Phone Number:
Cell Phone Number:

Home Address/Permanent Address

Local/On campus Address
   
Serial Number:
Make:
Model:
Color (Repainted?):
Fenders Hand Brakes Boys Girls Quick Release Wheels Quick Release Seat
Date of Purchase:
Value:
   
Features/additional equipment such as Ubolt lock, water bottle