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
Your answer
Phone number
Your answer
Email address
Your answer
General Nature of Complaint (check one):
Specifics regarding complain/concern:
Your answer
Previous actions taken regarding complaint (person(s) with whom you have spoken, date of conversation(s), other):
Your answer
Applicant's pledge
All information provided is truthful and accurately reported.
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