Family Name: First Name:
Student ID Number: Contact Telephone:
Mailing Address:
Suburb: Country: Postcode:
JCU Email Address: @my.jcu.edu.au
Student Advocate/Representative/Support Person
You may have a Student Advocate who can give you advice and assist with your complaint, or a support person.
If you have one of these, please provide their details:
Name: Position
(eg Student Advisor, friend, parent):
Email Address:
Information about how complaints are managed can be found at the Student Complaints webpages. The pro-
cedure for submitting a formal complaint is found in paragraphs 2.1-2.5 of the Student Complaint Management
Policy and Procedures. You can also contact the Student Complaints and Quality Improvement Unit on (07) 4232
1397 for advice.
After you submit this form, we will acknowledge this in writing. Your complaint will be referred to the relevant
senior manager within the University. A record of all actions will be kept.
The information you provide to us will be treated condentially. It will not be disclosed to a third party other
than to comply with the law or for the purpose of managing your complaint. The details of your complaint (in-
cluding your identity) may be shared with a person you are complaining about or potential witnesses.
Please use this form to submit a formal complaint to the university. It is intended to help you dene what the
problem is and tell us what you have already done to try and resolve it. It will also guide you in the types of
information needed to resolve your complaint. If there is more than one complainant, each complainant must
complete a separate form.
Complaint Statement:
Please provide a typed statement about your complaint that includes, where relevant:
(If there is not enough space for you to complete you complaint statement here please attach a separate statement to this form)
• A description of the events that have occurred;
Clearly explain who and/or what you are complaining about and how you have been adversely and unjustiably impacted. Try to
discuss events in chronological order: state their dates, times and locations, and the names of those who involved.
The steps have you already taken to try to resolve the complaint;
List your actions to date. Who have you spoken to? State why you have not been able to resolve the matter informally
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Student Complaint Form
Complaint Statement (continued):
The evidence you have to support each claim in your complaint;
Number each item of your evidence and refer to this as you discuss the evidence throughout your statement. Attach this evidence
to your complaint. Advise of any evidence you know of but do not possess.
The name and contact details of any witness or other person who may support your complaint;
• A summary of the basis for the complaint;
What do you reasonably think should have happened, been provided to you, or you could have expected?
The outcome/s you are seeking;
What you want to achieve by submitting a complaint cannot be guaranteed, but JCU will address your complaint within its legal
obligations and Policies and Procedures.
Your Agreement:
In submitting this complaint I agree that:
q I have read the information at Should I make a formal complaint, and paragraphs 2.1-2.5 of the Student Com-
plaint Management Policy and Procedures.
q I have written a clear and concise outline of the complaint and the resolution I seek and attached all relevant
evidence.
q The information I have provided in this document is a true reection of my experience and is not made for
frivolous or vexatious purposes.
q I understand that complaints that are found to be intentionally misleading or made for the purposes of
causing harm may result in misconduct proceedings.
q I will conduct myself appropriately, showing courtesy and respect when dealing with sta.
Your signature:
Date:
Where to send your completed complaint (marked “personal and condential”)
By email: StudentComplaints@jcu.edu.au
By mail: Director Student Services,
Student Complaints and Quality Improvement Unit
James Cook University
PO Box 6811
Cairns Qld 4870
Oce Use Only:
Date complaint received: Complaint Number SC:
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Student Complaint Form
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signature
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