Visitor Parking Waiver Form

If you are a visitor to our campus and you received a parking citation, please fill out and submit this form.

Last Name: *

First Name: *

Visiting: *

Date of visit: *

Month

Day

Year

Citation Number: *

Driver's License Number: *

State: *

Address: *

City: *

State: *

Zip Code: *

Phone: *

Vehicle Year: *

Vehicle Make: *

Vehicle Model: *

Vehicle Color: *

License Plate: *

State: *

I hereby certify that I was a visitor on the ULM Campus and request a waiver of this citation. I further certify that I am not a student enrolled in classes, or an employee of ULM. *

Yes

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

  _  __ __  __  _____            ____   ____  
 | |/ / \ \/ / |___ /    __ _   / ___| / ___| 
 | ' /   \  /    |_ \   / _` | | |  _  \___ \ 
 | . \   /  \   ___) | | (_| | | |_| |  ___) |
 |_|\_\ /_/\_\ |____/   \__,_|  \____| |____/

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