Student Grievance Form
Please submit completed form to the Dean of Students. Student has 10 business days from the date of the incident being grieved to resolve informally. Student MUST complete the Informal Student Grievance steps before filing a Formal Grievance.
Student's Name
*
First Name
Last Name
Student's Email
Contact Number
*
-
Area Code
Phone Number
Brief description of incident being grieved:
*
Resolution requested:
*
Has Informal Grievance Procedure Steps been completed?
*
Yes
No
If yes, list the outcome(s):
If no, please list why not?
Please attach supporting documents and/or contact information for witnesses (if any).
Signature
*
Clear
Submit
Should be Empty: