Student Concerns

Program/Department:
Question/Concern:

Question/Concern: Academic Extra-curricular Other Other
Please note that if requested, we will keep comments and questions confidential unless required by law to do otherwise. However, some circumstances may require further sharing of information. If you provide contact information, you will be contacted prior to any further action.
Would you like this kept confidential?
Name: Name: First Last
Student number:
Maximum of 9 digits allowed. Currently Entered: 0 digits.
Contact Information

How may we contact you? (Please list phone number or email)
Email:
Phone: Phone: - ### - ### ####
Please describe your concern:
Thank you for taking the time to write to us.