Student Grievance Form
Student Name
Email ID
Course
Class
Academic Year
Student Mobile No.
B.Sc.Nursing
G.N.M.
P.B.B.Sc
M.Sc.Nursing
First Year
Second Year
Third Year
Final Year
2017-2018
2019-2020
2020-2021
2021-2022
2022-2023
Area Of Grievance
Date Of indecent or Problem
Administration
Staff (Teaching)
Staff (Non-teaching)
Department
Student
Curricular activity
Extracurricular activity
Name of individual and / or department against whom the grievance is filed:
Describe your grievance/complaint in detail including date/time of occurrence with necessary specifications. Attach additional sheets if necessary, along with any documentation that will help describe and substantiate the complaint. If any witnesses are there, list names and contact details.
Grievance if any.......
I hereby declare that the information on this form is true, correct and complete to the best of my information and belief. I understand that Grievance information may be shared with college officials in order to conduct through investigation and any misrepresentation of information may result in disciplinary action, in accordance with college disciplinary policies.
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