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Complaint/Grievance Form
Please fill out the following information to activate a formal complaint or grievance.
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Date
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MM
/
DD
/
YYYY
Name
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Who is the complaint against?
*
Governing Board Member(s)
Administration( Director/Assistant Director)
Faculty or Staff
Students
Other:
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Date of incident.
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MM
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DD
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YYYY
Please explain what happened in detail.
Your answer
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