Student Non-Academic Complaint Form

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Student Non-Academic Complaint Form

The student complaint/grievance procedure is designed to provide a prompt and equitable means for resolving non-academic student complaints/grievances. The complaint/grievance procedure may be initiated by a student, group of students or potential student who reasonably believe that they have been subject to unjust action or denied rights that adversely affect their status, rights, or privileges as a student.

Background Information

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Complaint Against(Required)

Urgency of this report(Required)

Date of incident(Required)

Time of incident

Location of incident(Required)

Specific Location

Involved Parties

List

Name of Organization

Gender

Date of Birth

Phone

Campus Address

Press the (+) to add another party.

Name of Organization

Select Gender

Date of Birth

Phone

Campus Address

Questions

The Complaint/Non-Academic Grievance Form should be submitted immediately. This generally ensures the availability of all parties involved in the complaint. When completing the Non-Academic Complaint/ Grievance Form, the reporter is expected to respond to all of the following questions as it relates to the complaint/grievance:

What is the nature of the complaint/grievance?(Required)

What steps have you already taken to resolve the issue?(Required)

What resolution or outcome are you seeking from this process? Provide specific actions you would like to occur as a result of filing this complaint.(Required)

What is the best way to contact you?(Required)

E-mail

Phone

Text

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 10MB maximum total size. Attachments require time to upload, so please be patient after submitting this form 10MB maximum total size. Attachments require time to upload, so please be patient after submitting this form.

Drop files here or

Max. file size: 125 MB.

Student Non-Academic Complaint Form

Student Non-Academic Complaint Form