General Student Grievance (Complaint) Procedure Form

Grievance (Complaint) Information

Date of incident(Required):

This field is required.

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Select the date of the incident or the initial date of the incident.

Involved Parties

Please add each individual involved. This should include yourself (Complainant), as well as any individual, department, or office (Respondent) you are filing a Grievance or Complaint.

Name or Department/Office

Status

ID Number (If known/applicable)

Email address (If known/applicable)

Questions

Describe Complaint (Please provide a detailed description of your complaint):(Required) This field is required.

Describe Any Efforts You Have Made to Resolve Problem:(Required) This field is required.

What Resolution/Outcome Would You Like to See?(Required) This field is required.

Supporting Documentation

Please attach any supporting documentation. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Grievance (Complaint) Information

Involved Parties

Questions

Supporting Documentation

Submission