BMS Locker Problem Form
Please complete this form if there are any problems with your locker.
Sign in to Google to save your progress. Learn more
Email *
Student's name
Student's grade
Clear selection
Locker Number
Locker Combination
Please indicate below the problem you are having with your locker.
Please provide a phone number where you or your parent can be reached.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Orange City School District.

Does this form look suspicious? Report