Complaints Form

Students should read and review carefully the policies and procedures before filing a complaint in the Student Services – Important Documents.

Basic Information

Name

Initial

Last Name(s)

Primary Phone Number

Secondary Phone Number

Student ID

Campus

What Degree are you pursuing?

Details About the incident

Have you met with the involved faculty or staff before initating this procedure?

Yes No

Instructor's Email

Subject of the Complaint ( Reason )

Academic Term

Incident Date

Your complaint ( please share all details )

What have you done so far to address the complaint?

What would you like done about you complaint? ( Remedy )

I confirm that any statement included in my application from someone supporting my complaint has been provided with the explicit consent of that person.

I certify the information entered above is true to the best of my knowledge and belief.

If you have any document that will help to investigate and/or resolve this complaint, Please upload it below.

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Complaints Form

Basic Information

Details About the incident

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