Request an Advocacy Appointment

Please read the below JCUSA Advocacy Service Charter before filling out the below request form.

JCUSA Advocacy Service Charter 

Request an Advocacy Appointment

Full Name

Student Number


Phone Number


Degree Name

Year of Study

Preferred Date Please note: This is a preferred date only and does not guarantee you will receive an appointment on the selected date. An advocate will be in contact with you to make an appointment.

Preferred method of contact

Summary of concern Please provide a brief summary of the issue you'd like to see an advocate for.

I have read and agreed to the commitments laid out in the JCUSA Advocacy Service Charter (document located above)
I agree

Additional documentation

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