ELGIN COMMUNITY COLLEGE
SMOKING TICKET APPEAL
NAME ECC ID #
ADDRESS CITY, ZIP
PHONE # Date of Ticket
TICKET # EMAIL ADDRESS
REASON FOR APPEAL
SIGNATURE DATE
NOTE: ALL APPEALS MUST BE FILED WITHIN 10 CALENDAR DAYS OF OFFENSE
Please include a copy of the ticket and receipt of payment with your appeal for identification purposes. All
fines are to be paid within thirty (30) days of the date the citation was issued. Failure to pay this fine prior to
your appeal being reviewed will result in a hold on your student account and you will be unable to register for
classes, receive transcripts or class grades. You will be refunded if the appeal is in your favor. Enforcement
provisions and monetary fines for violations will be based on the Elgin Community College Smoke Free Campus
Administrative Procedure. The ECC Smoking Appeals Committee will meet once per month to review appeals
and will respond within 10 business days. Turn this form in to Business and Finance, Room B205.11. The decision
of this committee is final.
Disposition of this Appeal _________ Approved _________ Not Approved
Decision Mailed Back/date ____________Yes/No _________ Date
Date decision sent to Student Accounts __________________________________
Response _____________ See Letter _________________________________________________
Signature of Appeals Chair ________________________________________ Date ______________
