Copy of Complaints and Appeals Form

Complaints and Appeals
Complainant Name*

First NameLast Name
Date of Complaint:*

DayMonthYear
Date
Complainant Mobile:*
Please enter a valid phone number.
Complainant Email:*
example@example.com
Who is complaining? *
Who is the complaint against*
Form Submitted to*

First NameLast Name
Other Party/s Involved*

First NameLast Name
Appeals must be lodged within 7 days of the initial result being determined

Refer to the Complaints & Appeals Policy in the Student Handbook for procedure.
Details of Complaint/Grievance/Appeal
Have you discussed this matter with the Programs Coordinator or Head of Fulltime or your Trainer in an attempt to reach a decision?*
Details: *
If there is not enough space on this form for the complaint, please complete a Complaints Report Form, in addition to this form.
Will you be submitting a Complaints Report in addition to this form?
Signature*

Clear
Date Signed*

DayMonthYear
Date
Date Submitted

DayMonthYear
Date
Should be Empty:

Complaints and Appeals