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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 | __ )    ___   / ___| |___ /  __   __ |  \/  |
 |  _ \   / __| | |       |_ \  \ \ / / | |\/| |
 | |_) | | (__  | |___   ___) |  \ V /  | |  | |
 |____/   \___|  \____| |____/    \_/   |_|  |_|

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