EOSC Student Complaint Form

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Your Full Name

Your Email Address

Your Phone Number

Types of Complaints

Please provide detailed information and choose one of the following options based on the type of incident you are reporting:

General Incident – For general concerns or actions that are experienced or observed involving a student, faculty or staff member; or concerns that a student has violated the Student Code of Conduct.

Academic Issue – For incidents or violations involving violations of EOSC’s Academic Policies and Procedures.

Residence Hall Issue – For incidents or concerns involving an on-campus residence hall or apartment.

Safety Concern or Threatening Behavior – For concerns or actions that are experienced or observed and present a danger to an individual or the EOSC community. If this is an emergency, please contact Campus Police immediately at 918.465.1718.

Type of Complaint *

Description of Incident or Concern

Please provide a detailed description of the incident/concern using specific concise, objective language (who, what, where, when, why, and how).

Please also include any history of the incident (what steps have been taken previously to remedy this situation? What has been contacted and when?)

Full Name of Individual(s) Involved (student, faculty or staff)

Date of Incident

YYYY

Time of Incident

Time

Location of Incident

Cause of Complaint *

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This form was created inside of Eastern Oklahoma State College.