Student's Complaint Form

Personal Information:

Student's name: ….................................................... No.# ….............................

Shift: AM / PM Current Level …................ Previous level:................
Room: …........................................ Section: ….........................................
========================================================================
Complaint:
…..................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
…..................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
…..................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
…..................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................

========================================================================
Action taken:
1. By advisor:

…............................................................................................................................................................
..........................................................................................................................................................
....................................................................................................................................................

2. By Academic Manager:

…..................................................................................................................................................................
......................................................................................................................................................................
..................................................................................................................................
By ( Chair of Eng. Dept. or ):
…..................................................................................................................................................................
......................................................................................................................................................................
..................................................................................................................................
3. Final Comments:
…..................................................................................................................................................................
......................................................................................................................................................................
..................................................................................................................................