Fillable Csc-401a-student-complaint-form-twc Career Schools & Colleges Form CSC-401A: Student Complaint Form

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Csc-401a-student-complaint-form-twc Career Schools & Colleges Form CSC-401A: Student Complaint Form

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The Csc-401a-student-complaint-form-twc Career Schools & Colleges Form CSC-401A: Student Complaint Form form is 2 pages long and contains:

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Student Complaint Form
Texas Workforce Commission – Career Schools and Colleges
Pg 1 of 2 CSC-401A
PREVIOUS EDITIONS OF THIS FORM WILL NOT BE ACCEPTED REV 10/14
DEPT. US E O NLY
School #
Please complete all of page 1 & 2 of this form, sign it, and mail to: TWC-Career Schools and Colleges, 101 East 15
th
Street, Room
226T, Austin, Texas, 78778-0001; fax it to (512) 936-3111; or email it to career.schools@twc.state.tx.us. If you wish to confirm
receipt, please phone (512) 936-3100.
Unless you reveal your name and address, we are unable to investigate your complaint and may use this form for information only.
Please submit a copy of your enrollment agreement with the school and copies of any other documents that may help us
substantiate this complaint. DO NOT SEND ORIGINALS OF ANY DOCUMENTATION.
Your Full Name at Time of Enrollment
Name of School
Addres s
School’s Address
City
City
State Zip
State Zip
Home Phone
School Phone
Work Phone
Program Attended
Social Security Number
Last Date of Attendance (mm/dd/yyyy)
Please list the names and phone numbers of any witness es or persons who can s ubstantiate your complaint.
Who else have you contacted regarding this complaint?
Have you used the school’s complaint process? Yes No
If no, why not?
In your opinion, why was this complaint not resolved at the school?
How much tuition have you paid? How did you pay this? If loans were used, please list the names of the lenders and account
numbers of the loans.
Describe your complaint in detail. Include names of persons, locations, and dates involved. Please use additional sheets if
you need more space. If this complaint is against specific person(s), please list their name and title.
STUDENT COMPLAINT FORM CONTINUED
Pg 2 of 2 CSC-401A
PREVIOUS EDITIONS OF THIS FORM WILL NOT BE ACCEPTED REV 08/11
What relief or resolution would you consider fair?
I hereby certify that the above information is true and correct to the best of my knowledge and grant permission for
the complaint to be forwarded to the school for a response.
Signature Date (mm/dd/yyyy)
_________________________________________________________________________________________________________________
Completed forms, inquiries, or corrections to the individual information contained in this form shall be sent to the TWC Career Schools and
Colleges, 101 East 15th Street, Room 226T, Austin, Texas 78778-0001, (512) 936-3100. Individuals may receive and review information that TWC
collects about the individual by emailing to open.records@twc.state.tx.us
or writing to TWC Open Records, 101 E. 15th St., Rm. 266, Austin,
TX 78778-0001.
_________________________________________________________________________________________________________________
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Csc-401a-student-complaint-form-twc Career Schools & Colleges Form CSC-401A: Student Complaint Form

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Completed 10 February 2020

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