Select one Student Non-Student
Blinn ID: (Enter "000" if you are a non student)
Campus Bryan Brenham Schulenburg Sealy
First Name: Last Name:
Email:
Street Address:
City: State: Zip:
Citation Number (top of citation):
Blinn Parking Permit Number
Location of violation (see citation):
Violation 1: ----> Parked in Handicap Space Parked in Unauthorized Space Failed to Display Valid Permit Blocking Entrance/Exit Parked Blocking Driveway Parked over Painted Stripe Blocking Traffic Lane Parked in Service/Maintenance Parked in Fire Lane Failed to Yield right-of-way Parked on Grass No Parking Anytime Illegally Parked Parked in Visitor Space Parked Blocking Sidewalk Parked in Reserved Space
Violation 2: ----> Parked in Handicap Space Parked in Unauthorized Space Failed to Display Valid Permit Blocking Entrance/Exit Parked Blocking Driveway Parked over Painted Stripe Blocking Traffic Lane Parked in Service/Maintenance Parked in Fire Lane Failed to Yield right-of-way Parked on Grass No Parking Anytime Illegally Parked Parked in Visitor Space Parked Blocking Sidewalk Parked in Reserved Space
Other:
Date Received
Written Explanation:
