Bicycle/Property Registration Form

*Registration Type:

*What are you registering?

If you are registering your bicycle, here's how to locate the serial number (pdf - 2.04 MB).

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 or Campus Address

*Campus Department or Residence Hall:

*Office Room # or Residence Hall Room #:

Address (Name & Number):

City:

State:

Zip Code:

Phone #:

Permanent Address

*Address (Name & Number):

City:

State:

*Zip Code:

*Home Phone #:

Current Property Information

*Make:

*Model:

*Serial #:

*Color:

*Category:

*Miscellaneous Description:

Current Property Information 2 (optional)

Make:

Model:

Serial #:

Color:

Category:

Miscellaneous Description:

Current Property Information 3 (optional)

Make:

Model:

Serial #:

Color:

Category:

Miscellaneous Description:

Current Property Information 4 (optional)

Make:

Model:

Serial #:

Color:

Category:

Miscellaneous Description:

Current Property Information 5 (optional)

Make:

Model:

Serial #:

Color:

Category:

Miscellaneous Description:

Prior Property Registration (If Applicable)

Municipality:

State:

Decal or Engraved Number:

Expiration Date: