* K Number
* Ticket Number
* Date of Violation
* City and State
* Zip Code
* Phone Number
Basis For Appeal
By submitting this form you agree to the following - "I certify this information is true and correct, realizing any evidence of false testimoney shall be cause for referral of the case to the Dean of Students for appropriate action".
Please submit the appeal form online. If you have further questions, call 319-398-5561. The Violation Appeals Committee meets monthly. After submitting the appeal, you will be notified of the date and time of the next meeting. You are not required to attend the meeting, however it is your right to appeal your violation in person, if you wish. Within two weeks of the meeting, your appeal will be sent back to you with the decision.
Unpaid violation notices assume the same status as any college debt. Any decision of the Violation Appeals Committee is final. Violation Notices are to be paid at the Cashier's Office, 2nd floor Kirkwood Hall. This fine must be paid within 10 days of the decision.
(Do not write below this line)
Appeals Committee Decision ____________________________________________
Void _____________________________ Administrative Fee___________________