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