20-21 ATI General Complaint Form
This form is for general complaints and grievances in regards to Armadillo Technical Institute
Name of person filing complaint *
Address
Phone Number
Earliest Date of the problem/incident *
-
Month
-
Day
Year
Date
Description of problem
Has the issue been taken to the person/people involved in order to solve the problem together?
Yes
No
Other
Has an ATI staff member has been notified of the conflict?
Yes
No
Other
What is the name of the ATI staff member who was notified of the conflict and what date was it reported?
Have the parties involved have participated in mediation?
Yes
No
Other
If any of these steps were not taken, please explain why the ATI General Complaint policy was not followed.
I verify that all the statements and information are complete and entirely honest to the best of my knowledge. I understand that false statements make it difficult for everyone involved to find a reasonable and safe solution for all. False statements used to cause others difficulty may be considered harassment and those making them may be subject to further action.
Agree / Understand / Verify
By typing your name in the space provided below, you are signing this document electronically. You agree your electronic signature is the legal equivalent of your manual signature on this document.
Submit
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