Complaints and Grievances

Background Information

The more information provided here, the better able LCCC is to respond appropriately.

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this complaint(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Specific location:

Involved Parties

The more information provided here, the better able LCCC is to respond appropriately.

Name or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Incident Description (Please provide a detailed description of the complaint detailing what alleged action violates or inequitably applies to written college policy or procedures. You will also have a chance to attach copies/documents at the end of this report.)(Required) This field is required.

Please list, if any, the college officials or offices that you have spoken to regarding this issue and any outcomes from those interactions. If you have not contacted any college officials prior to filing this complaint, please type n/a.(Required) This field is required.

Please describe as clearly as you can, what would resolve this issue in a satisfactory manner, in your opinion.(Required) This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission