Concern Form

Name

Phone number

Email address

Room/Unit

Outline the primary concern in one sentence

What type of concern do you have?

Personal concern (affects you only)

Student life concern (affects the students of St. Paul's)

College concern (affects the students and staff at St. Paul's)

Both student life and college concern

Unsure

State the information you have gathered to gain further perspective on the concern:

What questions do you still need answers to?

What would you like to see happen to resolve this concern?