Student Conduct Grievance Request Form

Your information

Only your information is required. Do not add additional persons to this grievance request. Grievances must be requested on an individual basis.

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Your full name:

Your student ID number:

Your phone number:

Your Wake Tech email address:

Email address must be of a valid format.

Your program of study:

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What is your major while you are enrolled here

Date of Incident(Required):

This field is required.

Location of incident(Required):

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Which campus or site are you referencing in this report

If you are filing a grievance on a decision made by a faculty/staff person please indicate the name of the faculty/staff person below. If there is not another individual assoicated with this process leave the area below blank.

Name or Organization

Questions

Failure to follow the grievance process as outlined in the Student Handbook may result in your appeal not being heard. You may view the handbook here. Failure to provide accurate information to question number 1 will delay this process.

What date did you discuss this incident with your Instructor or College Official? Include the Instructor/College official's name.(Required) This field is required.

Have you discussed this incident with the Department Head(or College Official's Supervisor)? If the answer to the above question is yes, include the name and date below.(Required) This field is required.

Specific statement of grievance(Required) This field is required.

Incidents and/or facts supporting claim of grievance(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

Your information

Questions

Supporting Documentation

Submission