Student Concerns to Ombudsman

Student Contact Information

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Your full name:

Your phone number:

Your email address:

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Nature of your concern(Required):

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Date of incident(Required):

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Time of incident:

Involved Parties

Please list your name and M# here.

Complainant (Your) Name

M Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

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Supporting Documents

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Student Contact Information

Involved Parties

Questions

Supporting Documents

Submission