Vaqueros Grievance REPORT IT FORM

Reporter's Information

Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

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Please select a category

Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Specific location:

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Involved Parties (please include your information as well)

Name or Organization

Select Gender

Select Role

ID Number

Phone number

Email address

Hall/Address

Reason for Report and Description of Incident

Below are categories that may correspond to this incident, please indicate the relevant section that pertains to the incident.

General University Complaint

Complaint about a faculty member

Complaint about a staff member

Review of faculty drop from course

Complaint about a University Department

You must make at least one selection.

Description / Narrative Please describe in as much detail as possible the specific words, phrases and interaction of the situation. If the individual was loud or disruptive, indicate behaviors associated with the disruption, and describe any injury or damage to person(s) or property. Include name(s) of campus personnel you contacted and actions taken, if any. If you wish to remain anonymous, please state it clearly in the narrative. This field is required.

Please let us know what you would like to see as a result or outcome of this report.(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

Reporter's Information

Involved Parties (please include your information as well)

Reason for Report and Description of Incident

Supporting Documentation

Submission