FORM: STD 09.017 STUDENT COMPLAINT FORM

STUDENT COMPLAINT FORM
Please submit directly to Reception or Administration Department. It may take up to 10 working days to review the complaint from the date of submission.
STUDENT DETAILS (Optional):
Name

First NameFamily Name
Student ID
Contact Number
Address
Email Address
example@example.com
Course Name
COMPLAINT DESCRIPTION:
I request the college to address the following issue (please select)*

AcademicFinancialPersonalProceduralOther
Location of issue (if appropriate)
Date*

DayMonthYear
Date
Time*
Briefly describe the issue*
Details of the incident can be uploaded here (e.g. Picture/ Word File/ PDF etc.)

Cancelof
STUDENT DECLARATION:
I declare that all the information I have given above is correct and complete.
Student Signature*

Clear
Date*

DayMonthYear
Date
OFFICE USE ONLY
Received By
Signature

Clear
Date

DayMonthYear
Date
Issue discussed with (staff name):
Date

DayMonthYear
Date
Action taken
Resolved

YesNo
Refer to
Principal Review
Date

MonthDayYear
Date
Record Update:

YesNoN/A
Date

DayMonthYear
Date
FORM: STD 09.017 Student Complaint Form
LAST UPDATED: OCT 2017, Version No.1
Should be Empty:

STUDENT DETAILS (Optional):