Application for Redressal of Grievance/s
To,
The Chairman,
College Grievance Redressal Cell (CGRC)

Respected Sir/Madam,
I/We am/are hereby forwarding my/our application for Redressal of Grievance/s. Kindly accept it and do the further processing. My/our personal details and particulars about my/our grievances are as follows:
First Name of the Student *
Your answer
Middle Name of the Student *
Your answer
Last Name of the Student *
Your answer
Department
Your answer
Residential Address of the Student *
Your answer
Permanent Address of the Student *
Your answer
Email of the Student *
Your answer
Mobile No. of the Student *
Your answer
WhatsApp No. of the Student *
Your answer
Landline No. of the Student (If Any)
Your answer
Faculty *
Programme of Study *
Class *
Year of Study *
Semester *
Roll No *
Your answer
PRN No. *
Your answer
P.G. Registration No *
Your answer
Student Profile *
Your answer
Name of the Teacher/s / Officer/s / Staff /Section/s / Department/s against whom the Complaint is to be Lodged *
Your answer
Nature of Grievance/s in which Redressal is Sought *
Your answer
List of Supporting Documents Attached herewith (Supporting documents duly signed by student/s to be submitted within 3 days at the following e-mail address: pimsrgrievance@mes.ac.in) *
Your answer
Declaration from the Student/s (I/We hereby declare that the above information furnished by me/us is true to the best of my/our knowledge. In case if it is turned false I/We am/are personally responsible for the punishment.) *
MM
/
DD
/
YYYY
Place *
Your answer
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