IYAGNY Student Complaint Form
Email address *
Student Name *
Your answer
Primary Phone Number *
Your answer
Anonymous Complaint
By checking the "Yes" box below, I am directing that my name will not be disclosed to anyone other than the Executive Director (Edward McKeaney). If my complaint does not implicate the Association Director and/or the Faculty Liaison, the Executive Director may share my name with these, and only these, individuals in order to fully investigate the complaint. If my complaint does implicate the Association Director and/or the Faculty Liaison, the Executive Director may share my name with the IYAGNY Board President in order to fully investigate the complaint. Other than the individuals expressly mentioned in the foregoing, all information will be held in strict confidence unless I authorize its disclosure to others. After the complaint is filed, a determination will be made as to whether my complaint may be investigated and decided anonymously: that is, without disclosure of my identity to the accused or to other persons. If it is determined that it may not proceed as an anonymous complaint, then I will be given the option of either withdrawing the complaint or authorizing the disclosure of my name to others. Other than as set forth above, my name cannot be shared with others without my express consent under any circumstances.
Do you wish to make your complaint anonymous? *
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