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Student Grievance Form - Converse College
This form may only be reviewed and considered after the student has utilized all appropriate appeals at the department level.
Name of Student
General Nature of Complaint (check one):
Student Affairs (housing. food service, campus activities, athletics, intramurals, health/counseling, spiritual life, parking, student support, career development etc.) to be submitted to the Dean of Community Life
Academic Affairs (faculty, courses, schedule, advising, transcript, registration, etc.) to be submitted to the Provost
Business Affairs (financial aid, student account, student billing, Bookstore, information technology, work-study, housekeeping, facilities, landscaping/grounds,safety/security, parking ) to be submitted to VP for Finance and Administration
Title IX (sexual harassment, assault or misconduct) to be submitted to Title IX Coordinator
Other (general interaction with college offices)
Specifics regarding complain/concern:
Previous actions taken regarding complaint (person(s) with whom you have spoken, date of conversation(s), other):
All information provided is truthful and accurately reported.
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