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
Food Services
Custodial Services
Maintenance
Student Activities
Classroom
Health Services
Financial Aid
Grades
Sexual Harrassment
Housing
Student
Discrimination
Mailroom
Chapel
Other
IT Services
Safety and Security
Instructor
Library
Personal Records
Disciplinary Action
Non- Academic
Student Services
Provide a statement that briefly and clearly outlines the nature of your complaint.
*
What remedy or corrective action are you requesting?
*
