Complaint and Incident Notification Form

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IF THIS IS AN EMERGENCY CALL 911

Grace College and Seminary encourages individuals to formally notify the institution of any incidents or concerns they have been unable to resolve through other institutional procedures. Complaint notices are reviewed regularly but are not intended for emergency response.

The complaint processes for general institutional complaints as well as for complaints in online programs are on the institution's Student Right to Know page of its web site.

You will be asked to sign in to your Google Account to fill out the form, but your username and email will not be recorded. Notices can be submitted anonymously and Grace will do its best to investigate even without your contact information, but we will not be able to follow-up without it.

Do the best you can to complete all fields below so that your notification can be forwarded to the office responsible for investigating or responding to your report. No question is required.

Title IX Sexual Harassment or Non-Title IX Sexual Harassment complaints should be submitted using the online Title IX and Sexual Misconduct Report here.

Bias Incident reports should be submitted using the online Bias Incident Reporting Form here.

Academic Appeals and concerns can be addressed following this policy.

You may also notify Campus Safety at (574) 269-5344 or the RD on call at (574) 635-5737.

(updated 7/21/23)

Your full name.

I am:

A student

A faculty member or instructor

Staff, coach, grad assistant

Parent

Community member

Other

Clear selection

Phone number where you can be reached.

Email address where you can be reached.

Nature of this notification:

Academics

Accessibility

Admissions

Athletics

Business office

Dining

Housing

Financial aid

Personnel (faculty or staff) concern

Physical facilities

Policy violation

Security, threat, or criminal issue

Student conduct

Technology

Not sure

Other or general concern

Date of incident.

YYYY

Time of incident.

Time

Description of concern or what happened, including names of people involved, witnesses, specific location, and other relevant information.

Explanation of how you have already tried to resolve the problem, if any.

Explanation of specific action or resolution you are requesting, if any.

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