Student Governance Formal Complaint Form

The Office of Student Governance is committed to fair treatment of its community members and is open to comments and suggestions for involvement. Individuals are encouraged to seek an informal resolution of the matter, directly with the groups or individual(s) involved when possible. For matters where a resolution is not feasible, a formal complaint form can be completed and submitted via this form.

The information you provide will be treated as personal and sensitive, but it is not confidential. This means that Student Governance will not volunteer or deny any of the provided information to law enforcement or other university investigative bodies. It may be shared on a need-to-know basis with other offices.

I am a: *

I am a: Student Faculty Member Staff Member Community Member / Other
Name Name * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
Student/Employee ID (if applicable)
Title and Department (Faculty and Staff Members Only)
Name of group, department, or individual to whom the complaint is being filed: *
Location of Incident *
Date of Incident Date of Incident * / MM / DD YYYY
Time of Incident Time of Incident * : HH MM AM/PM
Statement of Complaint *
Upload a File

Attach Files

Attach documents (photos, reports, email, etc.) that are related to your complaint.
Actions to Resolve *
I attest that the information and facts provided in this document are true to the best of my knowledge.

I attest that the information and facts provided in this document are true to the best of my knowledge. I agree