Howard University School of Law Student Action Form
Please fill out the form below to the best of your knowledge and belief. All information provided is confidential and will only be used to resolve your complaint.
Today's Date *
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Student ID Number *
Your answer
First Name *
Your answer
Last Name *
Your answer
What is Your Classification *
Email Address *
Your answer
Phone Number *
Your answer
Mailing Address
Your answer
Preferred Method of Contact *
Is Your Complaint About a Person? *
Required
If "Yes" to prior question, choose only one person.
If your complaint is against multiple individuals, please submit a separate complaint per person.
Is Your Complaint About *
Describe the program, process, behavior or matter at issue. *
Please be specific and use names, dates, titles etc.
Your answer
What is the date the incident or issue began? *
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DD
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YYYY
Is this a recurring problem? *
Required
Have you previously filed a complaint for this issue? *
Required
If "yes" to the previous answer, please describe when you filed the complaint, and what, if anything, was done to resolve the issue.
Your answer
What attempts have you made to resolve the issue?
Please state any names of persons involved to help resolve the issue.
Your answer
What resolution do you seek?
Your answer
Any other information that you wish to disclose that could be pertinent to your matter.
Your answer
Is there any person you do NOT want to be involved in this complaint?
Keep in mind that it may be difficult to resolve your complaintif those involved cannot be asked to explain or respond. NOTE: RETALIATION AGAINST A STUDENT FOR MAKING A COMPLAINT IS ABSOLUTELY PROHIBITED AND WILL BE CONSIDERED A SERIOUS VIOLATION OF PROFESSIONAL RESPONSIBILITY.
Your answer
I hereby certify the above information is true and correct to the best of my knowledge and belief. I grant permission for this information to be forwarded to officials for the purposes of investigation and response. *
*By selecting "yes" you certify that the information provided is truthful.
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