Academic Advocacy Intake Form
STUDENT ASSOCIATION OF GEORGE BROWN COLLEGE
Date *
MM
/
DD
/
YYYY
Name *
Your answer
Last name *
Your answer
Student ID number *
Your answer
Phone number *
Your answer
Email *
Your answer
Program Code (example: T105) *
Your answer
Course Code (example: COMM1007 ) *
Your answer
Professor Name (example: John Smith) *
Your answer
Program Chair (example: John Smith)
Your answer
Semester *
Required
I authorize the Student Association Advocacy Staff to contact GBC Faculty/ Administration on my behalf. *
Issue or concern (Please briefly describe your issue or concern. You will be given the opportunity to add further detail later.) *
Your answer
How did you hear about the Academic Advocacy Program? *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms