Student Grievance Form

 

 

Name: _________________________________ Enrolment No.: _____________________

 

Email ID: _______________________________ Mobile No.: ________________________

 

Gender: ________________________________Batch: ____________________________

 

Reported Date of Grievance: _______________________ Academic Session: ___________

 

 

Grievance Category:

1. Academic
2. Non-Academic
3. Personal

 

Complete Detail of Grievance:

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Was Discussed or reported to anyone before?     Yes _____   No_____

 

If Yes to Whom? ___________________________________________________________________

 

Expected Outcomes you would like to see happen regarding this.

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Grade Appeal:

⮚     Concern

⮚     Complaint

⮚     Grievance

 

 

Signature