Student Complaint Form

Section 1: Personal Information

Please refer to the Student Complaints Policy before filling out this form. This form is to be used to submit a formal complaint after students have been unable to satisfactorily resolve with the faculty, staff, students or others involved. The Student Resolution Center provides conflict resolution services to assist students experiencing conflicts with faculty, staff, roommates, friends, family, and others.

Please complete all fields so your complaint may be directed to the proper university officials.

Complaints may be submitted anonymously; however, unless you include your contact information, CSU will be unable to investigate your complaint or respond back to you regarding the subject matter.

Types of Complaints:

Academic Undergraduate: This complaint pertains to a course, a professor/instructor, or advising at the undergraduate student level.
Academic: Graduate/DVM: If you are a graduate or DVM student and your complaint is related to classroom/coursework experience or research/creative artistry experience, e.g. situations within your graduate coursework, research/creative artistry, advising/mentoring relationships, or graduate assistantship.
Non-Academic: This complaint pertains to an outside the classroom/coursework experience such as with a policy, on-campus housing, financial aid, campus parking, a non-academic office or program, etc.

Please select the type of complaint that best describes your situation/need based on the descriptions above:(Required)

Your full legal name (as enrolled)(Required)

First Middle Last

Preferred Name

First Middle Last

Pronouns (optional)

CSU ID(Required)

Undergraduate Major or Graduate Degree Program

Expected Year of Graduation

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone(Required)

Preferred method of contact

Phone

U.S. Mail

Section 2: Information about your complaint

First date on which the events or issues occurred

Name(s) of the person(s) involved

Please describe your complaint in detail. Include the names of persons, locations, and dates involved. If this complaint is against specific person(s), please list their names and titles.

What attempts have you made to resolve this complaint up to now? Please state who you contacted and what transpired.

Why do you think the complaint was not able to be resolved in your prior attempts?

What resolution do you seek?

Any other information you want to provide?

For instance, is there any person who you do NOT want to be told of your complaint? (Keep in mind that it may be difficult to resolve if those involved cannot be asked to explain or respond). NOTE: RETALIATION AGAINST A STUDENT FOR MAKING A COMPLAINT IS ABSOLUTELY PROHIBITED, AND WILL BE CONSIDERED A SERIOUS VIOLATION OF PROFESSIONAL RESPONSIBILITY.

File

If attachments are necessary, please include as a .jpg or .pdf

Drop files here or

Accepted file types: jpg, pdf, Max. file size: 31 MB.

I hereby certify that the above information is true and correct to the best of my knowledge and belief. I grant permission for this complaint to be forwarded to CSU officials for purposes of investigation and response.

Colorado State University

Vice President for Student Affairs

Section 1: Personal Information

Types of Complaints:

Section 2: Information about your complaint

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