EmailMeForm
Student Complaint Form
The student complaint form is used to submit a grievance for any issue or concern you would like to be reviewed based upon the Shaw University Grievance/ Student Complaint Policy.
Name
*
First
Last
Email
*
Student ID Number
*
Submission Date
*
MM
/
DD
/
YYYY
Phone
*
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Major
*
Advisor Name
Semester
*
Select all that apply
2018-2019 Spring Semester
2019-2020 Fall Semester
2019-2020 Spring Semester
2019-2020 Summer Session I
2018-2019 Summer Session I
2018-2019 Summer Session II
Pertinent Information
Please provide as much detail as possible in this section. Any information you may provide may assist in resolving your issue/concern.
Name(s) involved
Name (s) involved
Please provide names of all involved in your concern /issue.
Date(s) of incident(s):
*
Date of incident(s)
Please enter the date of the incident.
Please indicate the type of complaint:
*
Select all that apply
Housing
Disciplinary Action
Mailroom
Instructor
Non- Academic
Food Services
Other
Student
Grades
Financial Aid
Library
Personal Records
IT Services
Safety and Security
Chapel
Student Services
Classroom
Student Activities
Custodial Services
Discrimination
Sexual Harrassment
Maintenance
Health Services
Provide a statement that briefly and clearly outlines the nature of your complaint.
*
What remedy or corrective action are you requesting?
*
