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Full Name *
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If you do not have a Park ID# please type 123456
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Email Address *
Phone Number
What is the nature of your complaint

Note: If you wish to appeal a final grade you’ve
received in a class, please use the official
Grade Appeal form located here

Date of Occurrence *
Course #/Section (i.e. AC201 DLA)
 
Concern/Complaint Summary *

Detailed Information - Please be specific & identify individuals
What is your desired outcome? *