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