Coppin Concerns Form Your Information First Name Middle Name Last Name CSU ID Number Major and Expected Graduation Date N/A if not applicable CSU Email Address CSU Email Address Confirm email Phone Number Your Concern Division/Department/Office involved Division/Department/Office involved - Select -Academic AffairsAdministration and FinanceInstitutional AdvancementInformation TechnologyPresident’s OfficeEnrollment Management & Student AffairsOtherOther… Enter other… Preferred Method of Contact Email Phone Date Issue Occurred Name of Individual Involved Please describe your concern in detail. Include the names of persons, locations, and dates involved. If this concern involves a specific person, please list their names and titles. What attempts have you made to resolve this concern up to now? Please state who you contacted and what transpired. Is there any other information you want to provide? Upload a file? Upload One file only.20 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, tif, pict, txt, rtf, odf, pdf, doc, docx, avi, mov, mp3, mp4, wav, gz, jar, rar, tar, zip. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
