Coahoma Community College
EMPLOYEE / STUDENT GRIEVANCE FORM
This form is to be used if the grievant is not satisfied with the oral decision of his or her immediate supervisor or
dean at the first step of the grievance procedure. This form will be completed at each subsequent step to which the
grievance is advanced. If a grievant is settled orally with the immediate supervisor or dean, this form should not be
!(READ!CA RE FU LL Y)
facts!and!documentation!directly!related!to!the !com plaint.!!Indicate !the!tim e!fram e !in!which!th e!violation s!refere nced!in!the!complaint!