Student Academic Grievance Submission Form
Student Information
Full Name
Student ID
Email Address
Program / Course
Grievance Details
Subject / Course Title
Instructor Name
Type of Grievance
Grade Dispute
Attendance/Absence
Unfair Evaluation
Policy Related
Other
Description of Grievance
Steps Taken to Resolve (if any)
Desired Outcome
Declaration
I declare that the information provided is accurate to the best of my knowledge.