Student Complaint Form - West Virginia Higher Education Policy Comission
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TUDENT
OMPLAINT
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Student Information
Full Name
Address
City
State
Zip
Home Phone Number
Work Phone Number
Cell Phone Number
Email
How do you prefer we contact you?
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home
work
cell
email
School Information
School Name
School Address
School City
State
Zip
Complaint Information
1. Did you follow the school’s grievance procedure to resolve your complaint with the school?
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Yes
No
Who did you contact? (list all with names and titles)
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2. Have you filed this complaint with another organization?
Yes
No
Organization’s Name:
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3. Do you have an attorney?
No
Yes Name:
4. Please attach a statement describing the nature of the complaint. The statement
should include a description of the events or circumstances upon which the
complaint is based and all supporting documentation for your complaint must be
attached. Specify any pertinent dates, staff you dealt with, monies owed,
balances due, etc.
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Parent category: Legal