Complaints Form

Personal Data

Name:*

Student Number:*

Contacts

Email:*

Phone:*

Other Informations

Description of the situation/complaint/request for help:*

What is the purpose of this contact?*

What result do you want to see accomplished?*

Have you informed the people involved of the reasons for this contact? No Yes

Have you already informed the person responsible for the unit involved? No Yes

If the answer to any of the above questions is no, please tell us why, and if you have spoken to a member of the academy about this, please state your name.