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