Kent State ID Number
   (9 Digits)

Date: 6/19/2019 9:13:04 AM
* First Name:
* Last Name:
  Contact Phone #:    Alternative Phone #:
* Email:

Current Address:

   Street:    City:
   State:     Zipcode:

* Areas of Concern (Select One) 

* Status:


Please Select One
* Undergraduate College / School:
* Graduate College / School:

Ethnic Origin(optional): (used for statisical purposes only)


To assist in the scheduling of an appointment with the Student Ombuds, what are the best days and times you are available?

Press submit to save your data and move to the next page. On the next page please give a brief description of your concern, the steps you have taken, and what resolution you are seeking. Include detail of dates, staff member names, offices contacted and any decisions communicated thus far.