The University of Memphis
Visitors Appeals Form
Click here for online help.

Name: Date:

E-Mail:

Address:    -
                    Street or Box/City/State/Zip

Telephone #: - -

Citation #:     License Plate #:

Reason for Appeal:


For Office Use Only



Verified by: ______________________________________________________

Disposition: Upheld Denied Reduced      Amount Reduced $ _________________

Comments:

Signature: _________________________________

The University of Memphis is an Equal Opportunity/Affirmative Action University.
It is committed to education of non-racially identifiable student body.