Paratransit Service
Dept. 4313 • 1000 E. University Ave. • Laramie, WY 82071
Phone (307) 766-9800 • Fax (307) 766-9804 • Email: tppara@uwyo.edu ● Website: www.uwyo.edu/paratransit
PARATRANSIT SERVICE APPEAL
REQUEST PROCESS (Please print legibly)
1. Complete all sections of this form. It is important that the information provided is complete and accurate.
2. Please include any supporting documentation. Additional pages may be added.
3. Eligibility appeals must be received within 60 calendar days of the denial. Suspension of service appeals must be received prior to
the start of the rider’s suspension.
4. Submit in any of the following ways:
Emailed to: Faxed to:
766-9804
Mailed to:
UW Transporation Services tppara@uwyo.edu (307)
Dept. 4313
1000 E. University Ave.
Laramie, WY 82071
Notification of the decision will be sent to the mailing and/or email address provided by the rider.
Reason for appeal:
☐ Appealing the decision to deny my paratransit service application
☐ Appealing the decision to suspend my paratransit service
☐ Other
In as much detail as possible please explain why you are appealing.
A representative will be in contact to set up a hearing with you. At this time, please tell the representative if you
need transportation to the hearing.
I understand that falsifying information in this appeal will result in denial of the appeal and may subject me to disciplinary action. I
further attest all information given is true, correct, and valid to the best of my knowledge and belief. After considering all of the facts relating
to the citation, I believe I have a fair just reason for appeal.
(Full Name) (Phone Number)
(Street Address/PO Box) (City, State, Zip) (Email)
(Signature) (Date)
In Person :
Paratransit Office -or- Transportation Services Office
403 S. 3rd Street Lower Level Service Bldg, #104
click to sign
signature
click to edit
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