Student Complaint Form
___________________________ __ _____________________________
First Name M.I. Last Name
______________________
Student Individual Number
Street Address: (at which you anticipate receiving your response)
___________________________________________________________________
Address
___________ __________________
Zip Code Country
____________________ ____
City State
_____________________
Telephone Number
____________________________________________
Huntingdon Email Address
Current Student Status:
Department:
Complaint Information:
Date of the event giving rise to the complaint: _______________________________________
State the nature of the complaint:
In greater detail, identify how the treatment of the student was in conflict with Huntingdon College
policies and procedures. Additional materials may be provided to directly substantiate your
complaint. Direct reference to the policy or procedure as well as the location of said policies are
useful in substantiating the complaint. All supporting evidence should be disclosed here as well.
This complaint will not be processed unless all the boxes below are checked and you have
signed and dates the complaint.
I have read the Student Complaint Policy for Huntingdon College and agree this form constitues
my formal complaint.
I hereby certify that all of the information I have given above is true and complete to the best of
my knowledge.
Student Signature:_______________________________________ Date:_________________
The completed form should be submitted to the Business Office to the attention of the Complaint Resolution Officer.
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