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Grievance Redressal Form

Grievance Form

Name

First

Last

Subject

Status Status

Basis of Complaint

Harassment

Discrimination

Unfair Action / Violation of Rights

Grievance is filed under:

Harassment and Non-Discrimination Policy

Staff/Admin General Grievance Policy

Preferred Method to Contact You:

What was the date of occurrence and what specific behavior, condition, or violation of policy or procedure occurred which you consider discriminatory, harassing or unfair / violated your rights?

How have you been adversely affected by this situation?

What specific action have you taken to follow the guidelines for informal resolution as outlined in the Grievance Procedures for Discrimination and Harassment or the Staff and Administrative Grievance Policy? What has been the outcome of these efforts?

What specific remedy do you request?

Your Message

If you are human, leave this field blank.

Grievance Redressal Form

SYNA

International College Of Management Studies

Katni (M.P), India