Citation Appeal Form

One form must be completed for each citation in question. No appeal will be accepted 72 hours after the citation has been written (Saturdays, Sundays, and holidays excluded).

Citation Number

Citation Date

Classification

Student ID (not require for faculty/staff)

First Name

Middle Name

Last Name

Campus Address (if applicable)

Box Number

Dorm

Phone Number

Home Address

City

State

Zip

Home Phone

Appeal

Use this space to state your appeal and any information pertaining to your case that may aid the Judicial Council in making its decision.

Appeal

All decisions will be finalized within two weeks.

I affirm that the information given in this application is accurate and complete to the best of my knowledge.

Additionally, I understand that entering untrue statements will lead to further judicial action.

By checking this box, I agree to the above statements

I agree

In lieu of a signature, please check if you agree to the statement above and state your full name.

Signature

Mississippi College

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Contact

Citation Appeal Form

Campus Address (if applicable)

Home Address

Appeal