Student Complaint Form

Confidentiality will be observed in the handling of complaints, but disclosure of personal or identifying information to relevant staff will generally be necessary in order to respond to your complaint. You will be notified of the outcome within 10 business days of receipt of the complaint. The College's Student Complaints policy [NeSCC Policy 03:05:10] can be accessed online in Chapter 3 of the Northeast State Policies and Procedures Manual.

* indicates required fields

STUDENT INFORMATION

Student First Name *
Student Last Name *
Student ID Number *

Student Email:
Telephone Number:
Alternate Telephone Number:

Date Completing Form:

DETAILS OF YOUR COMPLAINT *

Include information that describes your complaint or problem. Include details such as conversations or meetings regarding your complaint. Copies of documents that you feel assist in understanding the complaint may be submitted to the Dean of Enrollment Management and Dean of Students, C2110.

LIST ANY STEPS YOU HAVE TAKEN TO RESOLVE YOUR COMPLAINT *

Many times your concerns can be addressed by first contacting the staff or faculty directly. It is acknowledged that in some cases it is not possible for you to first raise the issue with others before completing an official complaint form.

WHAT OUTCOMES DO YOU EXPECT FROM YOUR COMPLAINT? *

ADDITIONAL COMMENTS

Student First Name *	Student Last Name *	Student ID Number *
Student Email:	Telephone Number:	Alternate Telephone Number:
Date Completing Form: