LCC Early Alert Form (Student)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students: Please use this form to report issues you may be eperiencing in one or more of your classes.

If you are looking for the form for Faculty, it is available at this link: https://goo.gl/forms/sYYJa1rUaA09Mr2q2

What is your first name? *

What is your last name? *

What is your LCC ID number? *

Please enter your LCC student email address. *

Your email address is in the format "firstname.lastname@student.labette.edu"

Please enter your phone number (with area code)

This is an optional field. If you do not provide your phone number, our first method of contacting you will be through your student email account.

How would you prefer we contact you to assist you?

Please email me at my LCC student email account

Please call me at the phone number provided above

Please send me a text message at the phone number provided above. I understand that I may incur charges from my mobile carrier for this service

Other:

Clear selection

Are you having issues in one particular class or several of your classes?

I'm having issues in one particular class.

I'm having issues in several or all of my classes.

Clear selection

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms