WCCC Student Complaint Form
Student Name _______________________________ Student ID # __________________________
E-Mail where you can be reached ______________________________________________________
Date and approximate time of the incident/issue: ________________________________________
Briefly describe the complaint and attach any supporting information
at is your proposed solution (if you have one)
nature ________________________________________________
Date ________________________________________________
e-mail this form to:
or deliver to Barbara Pratt in the Office of Campus
Operations. Your complaint will be assigned to the appropriate college official, who will contact
you shortly.
If this complaint is related to perceived harassment, discrimination, sexual harassment/assault or a
complaint about employee or student behavior, please contact the Title IX Coordinator, Ms. Sharon
Hint, at hintz@warren.edu or via phone at (908) 835-2356.
Date complaint received: Received by: