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