Website Accessibility Complaint/Request Form
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Email *
Date of Complaint
MM
/
DD
/
YYYY
First Name
Last Name
Phone number
Website address (or location) of accessibility problem:
Description of the problem encountered:
Solution desired
By entering my name in this block, I am adding my electronic signature.  This form is time stamped with my name and email address.  All revisions of this form will be kept on file.
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This form was created inside of Beckville ISD.