Student GRIEVANCE Form

Name

Phone

Type of Grievance: (Select One)

Academic Issue

Administrative Concerns

Harassment or Discrimination

Facilities and Infrastructure

Date

Location of Incident/Observation:

Description of Grievance:

Upload Relevant Document if Required

Please describe your desired outcome or resolution for this grievance:

I would like to receive an acknowledgment of my grievance submission via email:

Yes

I understand and agree that the information I provide will be treated confidentially and only shared with the relevant authorities for the purpose of resolving my grievance:

Yes

Signature (Type your full name to acknowledge the submission of this form):

By submitting this grievance form, you confirm that the information provided is accurate and true to the best of your knowledge. Misrepresentation of facts may result in further action.

Contact Info

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Student Grievances

Student GRIEVANCE Form