STUDENT COMPLAINT FORM
STRICTLY CONFIDENTIAL
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CAMPUS *
Full Name of Student as per School Records (in Block Letters) *
Grade *
Section
Type of Complaint(Briefly explain) *
Date of Incident *
MM
/
DD
/
YYYY
Approximate Time *
Name of Staff Involved *
Witnesses, if any
Was there any earlier incident like this?
If so, details thereof , staff involved including approximate date
Have you brought this incident to any one’s notice, if so, details thereof
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