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DPP Appeal Form

University Housing» DPP Appeal Form

Fields with a BOLD font are required.

Name:
Address:
Email:
Phone:
Date Of Damage / Date Notice Posted:
Type of Charge:
Description of Damage:
Actions taken to rectify damage:
	(Find student(s) responsible, clean, etc.)
Reason for Appealing:
Additional Information:
If you are not responsible, who should be charged and why?:

University Housing
170 Price Commons
University of Wisconsin-Stout
Menomonie, Wisconsin 54751
Phone: 715/232-1121

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Updated: November 3, 2009 © University of Wisconsin Board of Regents