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