Student Complaint Form

Please refer to the Student Complaints Policy before filling out this form. This form is to be used to submit a formal complaint students have been unable to satisfactorily resolve with the faculty, staff, students or others involved.

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.

Student Complaint Form

Section 1: Personal Information

Your full legal name (as enrolled)

Preferred name

Major

Expected Year of Graduation

Mailing address

City

State

ZIP

Your preferred email address

Telephone

Preferred method of contact
email
phone
U.S. mail

Your CSU ID

Last date of attendance (if not currently in attendance at CSU)

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 would you consider fair? What resolution do you seek?

Any other information you want to provide?

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.

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.

Any other information you want to provide? If attachments are necessary, you may include them after clicking the “Next” button below.

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