Raise a concern form

1

What's your Student ID Number?* This field is required.This is found on your ID Card

2

What's your name?* This field is required.

First Name

Last Name

4

Tell us why you are concerned* This field is required.Tell us as much information as you can, do include names or courses if possible.

5

Which campus do you study at?* This field is required.

Amersham

Aylesbury

Wycombe

Elsewhere

6

How would you like to be contacted about your concern?* This field is required.Tick as many as you wish

College Email Address

Personal Email Address

Mobile Phone call

I dont want to be contacted further if possible.

7

Enter your mobile phone number* This field is required.

Please enter a valid phone number.

8

Enter your personal email address* This field is required.

example@gmail.com

9

Report ID

10

email concat

11

email suffix