Student Complaint Form

It is preferred that you attempt to resolve the conflict at the lowest level possible, meeting with the person(s) involved. Your matter will be received by the Dean of Students/Vice President for Student Affairs and will be forwarded to the appropriate academic or non-academic area as appropriate.

The University of Jamestown Formal Student Complaint Policy can be found in the Student Handbook

The following form is not for maintenance requests. Students should refer any maintenance requests to their Resident Assistant (RA), Resident Director (RD) or the Dean of Engagement and Student Affairs.

Name*

First Last

Residence Hall and Room Number

Off-Campus Address

Street Address Address Line 2 City State ZIP Code

Email*

The best email address where you can be contacted.

Cell Phone

The best phone number where you can be contacted.

First date on which the events or issue occurred

Name(s) of the person(s) involved

Please describe your complaint in detail. Include the names of person, location and dates involved. If this complaint is against specific person(s), list their names.*

What attempts have you made to resolve this complaint up to now? State who you contacted and what transpired.

Why do you think the complaint was not able to be resolved in your prior attempts?

What resolution would you consider fair? What resolution do you seek?

Any other information?

Attach file option

Max. file size: 100 MB.