Academic Advocacy Intake Form
STUDENT ASSOCIATION OF GEORGE BROWN COLLEGE
Date
MM
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DD
/
YYYY
Full name (last name and first name)
Your answer
Student ID number
Your answer
Phone number
Your answer
Email
Your answer
Program
Your answer
Course
Your answer
Professor/Chair
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?
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