Student Grievance from

All grievances will be handled according to the process outlined in the Student Complaints and Grievance Policy.

This Policy is located at: https://plc.ac.ae/resources/

Name*

Phone*

College ID*

Email*

example@example.com

Name of individual and or department against whom the complaint/grievance is filed*

Describe your complaint or grievance in detail, including the date(s) of occurrence (be as specific as possible). Attach additional sheets if necessary, along with any documentation that will help describe and substantiate the complaint. Are there any witnesses who should be interviewed? If yes, please list their names and contact information*

Students are encouraged to discuss their concerns and complaints through informal conferences with the appropriate instructor or department. Have you attempted to resolve this complaint or grievance with the individual and/or department involved? Yes / No*

If yes, describe the outcome:

What outcome do you hope to achieve after speaking with the appropriate college official(s)?*

Attach additional sheets if necessary

I understand that the information contained in this grievance form will be kept confidential to the extent possible. Grievance information may be shared with college officials to conduct a thorough investigation. I hereby declare that the information provided on this form is true, correct, and complete to the best of my knowledge. I understand that any misrepresentation of information may result in disciplinary action in accordance with college disciplinary policies.

Student Signature*

Date*

Date

STUDENT GRIEVANCE FORM