Mountain Education High School
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First and Last Name:
Address:
Phone Number (Including Area Code):
Email Address:
Description of the complaint or request:
Location of Accessibility problem or request.  Please give a web address and an explanation of the location.  
Solution Desired:
Signature:
Date:
MM
/
DD
/
YYYY
Your input is very important to ME and we appreciate you taking the time to fill out our Website Accessibility Form.  If we need additional information we may contact you.  Please allow us 2 weeks from the date of submission to process your request/complaint .  
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