Southwest Texas Junior College Employee Complaint Form

Southwest Texas Junior College Employee Complaint Form - Level One

SOUTHWEST TEXAS JUNIOR COLLEGE

EMPLOYEE COMPLAINT FORM – LEVEL ONE

Any employee filing a complaint under SWTJC Policy DGBA must fill out this form

completely and submit it to the lowest level administrator who has authority to address

your complaint, unless another process is required under the Policy. All complaints will

be processed in accordance with Policy DGBA (LEGAL) and (LOCAL) or any

exceptions outlined therein.

EMPLOYEE NAME_____________________________________________________

ADDRESS: _____________________________________________________________

TELEPHONE NUMBER: ________________________________________________

EMPLOYMENT POSITION______________________________________________

DEPARTMENT/CAMPUS________________________________________________

If you will be represented in presenting your complaint, please identify the person

authorized to represent you.

Name: __________________________________________________________________

Address: ________________________________________________________________

Telephone number: _______________________________________________________

Please state the date of the event or the dates of any series of events causing the

complaint:

Please identify each person against whom you are making your complaint, if any:

Please describe the decision or circumstances causing your complaint (give specific

factual details including relevant dates and identification of persons involved, if any – use

additional pages if needed):

Southwest Texas Junior College Employee Complaint Form - Level One