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SBG Complaint Form
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First Name
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Your answer
Last Name
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Your answer
Email Address
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Your answer
What is your school year?
*
Undergraduate
Graduate
Faculty
Staff
What do you identify as?
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Female
Male
Transgender
Non-Binary
Gender-fluid
Preferred not to answer
Other:
How would you describe yourself as?
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Deaf
DeafBlind
DeafDisabled
Hard of Hearing
Hearing
What is your ethnicity?
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American Indian or Alaska Native
Asian or Middle Eastern or Desi
Black or African American
Hispanic or Latino or Spanish Origin of any race
Native Hawaiian or Other Pacific Islander
White/ European American
Two or more races and/or ethnicities
Other:
Complaint Details
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Your answer
How can SBG help you to resolve your complaint?
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Your answer
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