Fillable Complaint Form University Complaint Form (Alabama A&M University)

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Complaint Form University Complaint Form (Alabama A&M University)

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Alabama A&M University University Complaint Form Staff Employee Grievance/Complaint Form
Office of Human Resources January 2016
Page 1 of 2
University Complaint Form
This form should be used to file a complaint or concern, or experience a problem that affects you or your co-
worker(s). Please complete this form within five (5) working days after the incident or problem first occurred.
The Office of Human Resources will contact you within 48 hours after receiving the complaint form.
Personal Information
Date:
Name: Contact number:
Address: City and State:
Employment Information
Position: Department:
Status: Faculty Staff Other (specify):
Immediate Supervisor: Telephone number:
Complaint/Concern Information
Date of Incident: Time of Incident:
Location of Incident:
Please describe in detail the specific act(s) of the complaint and/or concern. You may use additional sheets.
Alabama Agricultural and Mechanical University
Office of Human Resources
Mailing Address: Human Resources, Alabama A&M University, Normal, AL 35762
Phone: 256.372.5835 Fax: 256.372.5881
Alabama A&M University University Complaint Form Staff Employee Grievance/Complaint Form
Office of Human Resources January 2016
Page 2 of 2
Are there others who have witnessed this behavior or others who have experienced a similar concern or problem? If so,
please provide their name(s) and telephone numbers.
Did you raise this complaint/concern with your immediate supervisor or any other manager/supervisor at the University?
Yes No If yes, please provide the name(s).
What were the results from the University management?
Do you have any suggestions for proposed action to address or resolve the complaint/concern?
Please return the form to the Office of Human Resources.
Signature: Date:
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Complaint Form University Complaint Form (Alabama A&M University)

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Completed 25 July 2020

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