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Parking Citation Appeal Form

Hope College Department of Campus Safety
178 East 11th St.
Holland, Michigan 49423
(616) 395-7770

*APPEAL FORM MUST BE SUBMITTED WITHIN 30 DAYS OF THE CITATION*

*APPEAL FORM MUST BE FULLY COMPLETED TO BE VALID*

Personal Information:

Email:
Name:

Hope ID #:

Phone / Cell Phone #:
Faculty / Staff Department:

Ticket Information:

Ticket #:
License Plate #:
Date of Ticket:
Time:
AM PM
Permit # :
Expires:
Location:

Nature of Appeal:

In the space provided below, state with clarity, all reasons and basis for your appeal.

By submitting this form, I certify that the above written statement is a true and accurate statement of my appeal. Any false statement on this form is a violation of College Policy.