Student Complaints

Background Information

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Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Student ID Number (A Number):

My complaint is regarding a:(Required):

This field is required.

Date of Incident(Required):

This field is required.

Time of Incident:

Location of Incident(Required):

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Specific Location:

Involved Parties

Name or Organization

Select Role

ID Number

Email address

Questions

Describe the complaint including date(s) and act(s) that occurred.(Required) This field is required.

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

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

Supporting Documentation

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Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission