1. Please describe the ethical issue/conflict/dilemma.

2. What question do you want answered?/What is your comment?

3. Was the situation resolved?? What is you opinion?

4. Demographic Information (Person submitting comment)

Student                     Program   

Faculty                     Program   

M-DCC personnel    Campus   

Other:                      Community

               
                Name                                                          Date
       
          E-mail address

Situation may be placed on web site with demographic information only

Situation may be placed on web site with my name and short biographical information