Student Complaint Form
A Number (student ID)
Please enter a valid phone number.
Area of Complaint
Instructional (Blackboard/Technical Assistance)
Have you attempted to resolve?
When did the event/issue occur?
How were you referred to this form?
Referred by a faculty member
Referred by a staff member
Referred by a student
Please describe your complaint in detail. Include the names of person(s) involved, location(s), and any additional relevant dates. If this complaint is against a specific person(s), please list their name and title.
What attempts have you or others made to resolve the complaint? State who was contacted and what transpired.
Why do you think this complaint was unable to be resolved by prior attempts?
What resolution would satisfy your complaint?
Which units (departments. offices, programs) are involved with this complaint?
Is there any additional information you wish to provide or any person(s) you do not want to be told of your complaint? (Please know that it can be difficult to resolve complaints if involved persons cannot be asked to explain or respond to your complaint. Retaliation of any kind is strictly prohibited and should be reported).
Are there any relevant documents you would like to attach? (10MB limit)
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Choose a file
Email me a copy of this report
Should be Empty: