From: <[required-email]>
To: Appeals <appeals@library.wisc.edu>
Subject: Appeal of Charges

Please print or file a copy of this page for your records.


I.D. Number: [required-ID-number]
Your name: [name]
Address: [address]
City: [city]
State:  [state]
Zip: [zip]
Phone: [phone]
E-mail address: [required-email]

Reason provided:

[required-reason] 

Explanation statement:
[explain]


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You will receive a notification of the decision of the appeal board via email.
Call 608/263-7360 during office hours or email appeals@library.wisc.edu if you 
have questions.  

If you do not receive a reply within three weeks, it is your 
responsibility to contact this office.