Grievance form

The grievance flowchart can be found in the Student Handbook.

A grievance must be completed and submitted within five (5) calendar days of the incident.

Name of grievant:

E-mail address:

Phone number:

Mailing address:

Campus:

Danville

Charleston

Type of grievance:

Academic

Non-academic

Did you review the grievance policy in the student handbook?

Yes

Did you attempt to resolve the grievance informally?

Yes

Date of informal resolution attempt:

With whom did you attempt informal resolution?

Describe the discrimination, harassment, capricious and/or arbitrary policy, or improper conduct.

List all individuals and witnesses involved.

Expected resolution

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