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Fort Hays State University
Traffic Appeal Form
Name:
Date:
Address:
Phone:
Permit Type:
Permit Number:
Citation Number(s):
Classification:
Permit requested:
Instructions: Appeals must be filed within FOURTEEN calendar days of the citation. Failure to properly display parking permit, parking for a short period, not being familiar with parking regulations, and not seeing the signs do not constitute grounds for appeal. IN THE "Reason for Appeal" SPACE BELOW, state with clarity all reasons and basis for appeal. It is recommended that a diagram be attached in the field named "Attachments" when it will provide great clarity. Written notification of the Traffic Committee's recommendation will be sent within five(5) calendar days of a committee meeting.
Reason for Appeal:
Attachments:

List name, address and telephone number of employer(s) below:

Name: Address: Telephone:
Name: Address: Telephone:

Work schedule: Include day, times, and location(s) of employment:

By submitting this request, I hereby certify that the above is a true and accurate statement of my appeal.
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Traffic Appeal ©2003 Fort Hays State University. All Rights Reserved.