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One form must be completed for each citation in question. No appeal will be accepted 120 hours after the citation has been written (Saturdays, Sundays, and holidays excluded).

Campus Address (if applicable)

Home Address


All decisions will be finalized within two weeks.
I affirm that the information given in this application is accurate and complete to the best of my knowledge. Additionally, I understand that entering untrue statements will lead to further judicial action.
By checking this box, I agree to the above statements
In lieu of a signature, please check if you agree to the statement above and state your full name.