1201 Arrow Avenue
PO Box 730
Watertown, SD 57201
(605) 880-5284
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COMPLAINT FORM
Lake Area Technical Institute is committed to investigating and resolving complaints from students,
parents, faculty, and staff. As outlined in the grievance and complaint procedures in the student and
employee handbooks, the first step is to try to resolve the issue with the individual or supervisor involved.
If a resolution is not attained, the formal complaint process can be initiated.
To issue a formal complaint, please complete this form and submit to the Vice President.
Please print or type all information on this two page form.
COMPLAINANT INFORMATION
Last Name: First Name: Middle Name:
Address:
City: State: Zip Code:
Telephone: E-mail Address: Date of Complaint:
Program:
Please check the box which best describes your status with the institution: Student Faculty/Staff Other
If a student, provide the following information:
Start Date of Attendance:
Last Date of Attendance: Student ID No. or Social Security Number:
Which category most accurately describes this complaint?
Academic – Instructor Complaint
Academic – Grade Appeal
Academic – Other _____________________________
Student Services – Customer Service
Student Services – Accommodations
Student Services – Other _____________________________
Human Resources – Employee Complaint
Financial – Appeal of Charges
Title IX – Sexual Misconduct
Which department(s) or individual(s) are involved in this complaint?
