EmailMeForm
Shaw Univeristy Student Complaint Form
The complaint form is used for students to submit a grievance for any issue or concern you would like to be reviewed based upon the Shaw University Grievance/Complaint Policy.
Name
*
First
Last
Email
*
Student ID Number
Submission Date
*
MM
/
DD
/
YYYY
Phone
*
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Major
Advisor Name
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
Health Services
Other
Student Services
Personal Records
Financial Aid
Grades
Food Services
Custodial Services
Non- Academic
Classroom
Maintenance
Student Activities
Student
Chapel
Safety and Security
Housing
Disciplinary Action
Mailroom
IT Services
Discrimination
Library
Sexual Harrassment
Instructor
Provide a statement that briefly and clearly outlines the nature of your complaint.
*
What remedy or corrective action are you requesting?
*
