Appeal Form

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Please enter information in the fields below. Please state all relevant information.

Citation Number:

Select Date of Citation from Calendar:

Vehicle License No:

Issuing State:

Permit Type:

Permit No:

Appellant

First Name:

Last Name:

PLNU ID No:

Please indicate the address to which you want to have the letter of disposition sent.

Address:

Residence Hall (if applicable):

City:

State:

ZIP:

Telephone Number:

Email Address:

Enter a valid email address. Example: name@company.com

Your email address to receive a confirmation email. Please resubmit your appeal if you don't receive your copy.

Enter a valid email address. Example: name@company.com

Reasons for Contesting Citation:

I have read and understand the requirements and instructions of this form. By clicking "Submit", I am affirming that all information I have stated is true and correct to the best of my knowledge and that I am the person whose information is on this form.

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Point Loma Nazarene University

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Appeal Form