Student Organization Complaint Form
Name of student organization that is the subject of your complaint:
Your answer
Describe the alleged violation:
Your answer
When did this occur?:
MM
/
DD
/
YYYY
Where did it occur?:
Your answer
How was identification of the group determined?:
Your answer
Name of individuals present and/or involved with the above incident:
Your answer
Name of witnesses or other individuals with first-hand knowledge:
Your answer
Which entity sponsored the event? (Club, ASI, outside sponsor, etc.):
Your answer
Did you file this complaint with any other entity? (UPD, Safety & Risk, other campus affiliate, organization's advisor, local police?) Please identify:
Your answer
Your first name:
Your answer
Your last name:
Your answer
If you are a student, please enter your CSUB ID#:
Your answer
Your phone (with area code):
Your answer
Your organization (if none, put "NA")
Your answer
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