SUBMIT COMPLETED FORM TO THE PARKING & TRANSPORTATION SERVICES OFFICE601 SOUTH COLLEGE ROAD • WILMINGTON, NC 28403-5914 • 910.962.3178 • WWW.UNCW.EDU/PARKING

Student Community Service Application | 2019 - 2020

Student Name:

Cita�on Number: Cita�on Date:

Telephone Number:

ID Number:

Email Address: @UNCW.EDU

OFFICE USE ONLY

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Eligible Citation Types (hours)

Loading Zones (5)Non-Parking Area (3)Out of Zone or Faculty/Staff (3)

Reserved Parking (5)Restricted 7 a.m. - 5 p.m. (3)

Restricted Lot or Zone (3)Service Vehicle Only (5)Time Limit Exceeded (3)

Tow Away Zone (5)Visitor Parking (3)

*Handicapped and Fire Lane Viola�ons are not eligible for community service hours.

Day Time Total Hours

Example: Monday 2:00 p.m. - 5:00 p.m. 3

I (full name) agree in exchange for the waiver of the cita�on indicated above, I will complete community service hours indicated below. I understand the terms of this agreement listed below.

Limited to one (1) community service exemp�on per semester.Student is required to complete community service hours within 15 days of approval of community service agreement and within 15 days prior to the end of the academic semester. If the student fails to complete the scheduled community service hours, the cita�on will be reinstated for the full amount and the student will lose the community service op�on for the semester. If a student chooses to perform community service, the student waives the right to submit an appeal for the cita�on.

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Community service hours are available Monday-Thursday, 8:00 a.m. - 9:00 p.m., Friday 8:00 a.m. - 4:00 p.m. Service hours to be completed in Auxiliary Services, Parking or Enforcement areas.

Student Signature: Date:

NOTICE: Community service hours are available to permit holders only.

Agreement Approved by: Date:

Entered in T2 Flex by: Date:

Completed Service Approved: Date:

Failure to Complete Service: Date:

Indicate One:

Rev 07/19