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General Complaint Form

General Complaint Form

Indian Hills Community College wishes to address general complaints received from students, employees, and community members. If you have a complaint and wish to have it addressed, please complete the form below and it will be routed to the appropriate college administrator. Indian Hills Community College will make every reasonable effort to process a complaint to conclusion as expeditiously as possible or in compliance with specified complaint procedures and processes.

Note: This is a general complaint form. If your complaint is related Title IX/Gender Based Misconduct, Online Learning, Student Conduct/Concerning Behavior, or a Discriminatory Practices. Select from the following forms:

Click here for the Student Academic Integrity Form.

Click here for the Title IX/Sexual and Gender-based Misconduct Form.

Click here for the Student Conduct/Concerning Behavior Form.

Click here for the Grievance Procedure for Discrimination Form

Non-Discrimination Policy: It is the policy of Indian Hills Community College not to discriminate on the basis of race, creed, color, sexual orientation, gender identity, national origin, sex, disability, religion, age, political party affiliation, or actual or potential parental, family or marital status in its programs, activities, or employment practices as required by the Iowa Code sections 216.9 and 256.10(2), Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. § 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C.§§ 1681 – 1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).

If you have questions or complaints related to compliance with this policy, please contact Associate Dean, Student Development, 525 Grandview Ave, Ottumwa, IA 52501, (641) 683-5155, equity@indianhills.edu (students, faculty and staff); Executive Dean, Centerville Campus and Learning Services, 683-5174, learningservicesequity@indianhills.edu (students with disabilities); Director of the Office for Civil Rights U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, phone number (312) 730-1560, fax (312) 730- 1576, ocr.chicago@ed.gov.

Student Information

Please fill out all required fields

Your full name:

Your role:

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(student, employee, etc.)

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

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Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Specific Course/Instructor:

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Provide course name/instructor name

Involved Parties

Please provide the following information for all involved parties. Please be sure to list yourself in this section

Name or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Questions

Please answer the following questions about the complaint being filed.

Please describe the nature of your complaint.(Required) This field is required.

What have you done to resolve the situation? This field is required.

What outcome are you requesting? This field is required.

What is the best way to contact you regarding your complaint?(Required) This field is required.

Supporting Documentation

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Attachments require time to upload, so please be patient after submitting this form.

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