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Student Appeal/Complaint Form

Complete the following information then click the Submit button

* Name:

* Student Number:

* Current Address:

Street number (and apartment number, if appropriate)
* City:  * State:  * Zip: 

* Phone:

* LCC E-Mail Address:

* Course Number:

* Semester/Year Course Was Taken:

* Course Title:

* Grade Received:

* Faculty Member's Name:

The process requires you to first meet with your instructor to resolve the issue. If you haven't already done so, please discuss the issue with your instructor before completing this form.

* Did you meet with the instructor about this issue?


Nature of the Appeal/Complaint

* What decision or action is being appealed? Why is it considered wrong? What documentation, if any, can you supply?

Desired Settlement

* Explain what decision or action you believe would be appropriate.

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* Required Fields

Student Affairs Division

Student Affairs Division
Gannon Building
2nd Floor - StarZone
Phone: (517) 483-1200
Additional contact information »

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