ELI Formal Complaint Form

To the Director of English Language Institute
(and for possible submission to the Dean of Program, Continuing Education and Community Engagement)

Student Making Complaint

Student ID Number

Email

Provide email if you want follow-up

Name

Position

Is your complaint against more than one faculty/staff member?

YesNo

Additional Faculty/Staff Members

Name

Position

Complaint

Briefly state what you believe the faculty or staff member has done or failed to do which is the basis for the complaint.

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