Kent State ID Number
   (9 Digits)

Date: 4/23/2014 2:38:53 AM
* First Name:
* Last Name:
  Contact Phone #:    Alternative Phone #:
* Email:
   Major:

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)



Gender: 



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




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