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Student ID Number:
Address:
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Date of Event:

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Department or Staff Involved:

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Description of Complaint:

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What is a Fair Resolution to Your Problem?:

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= six + two

Please enter the security code to complete your application.
Please answer with either a number (ex. 7) or with the words “true” or “false”

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Fax: (323) 953-4029
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Fri 8:00 am to 2:00 pm

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[1 (888) 930 - 5222]

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Los Angeles City College | 855 N. Vermont Avenue, Los Angeles California 90029

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Phone: 323.953.4000

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Emergency: 323.953.2911