Student Complaint Form

Step
Step

General Information

Complainant

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip

Country

Phone Number

Program of Study

Last Date of Attendance

Is this an academic matter? If yes, stop here and refer back to the College’s Academic Appeals process. Please exhaust all steps in the process before filing a complaint with the Dean of Students.

Have you contacted another agency or organization about the matter? If yes, please give name of agency.

Have you contacted an attorney? If yes, please give name of attorney.

Complaint * Describe your complaint in detail. Specify any dates, staff you dealt with, monies owed, balances due, etc. Use additional paper/space as necessary. Attach any documentation which will help describe the problem and substantiate your allegations, such as an enrollment contract, correspondence with or from the institution, etc. Do not submit original documents as they may not be returned.

Signature *

I certify that the above information is true and correct to the best of my knowledge and grant Central Alabama Community College permission to release my name and complaint details to individuals investigating the complaint.

This form may be submitted to the Office of Dean of Students on the Alexander City campus or e-mail to deanofstudents@cacc.edu. You can also submit it by clicking the submit button below.