Complaint Resolution Log Form

     Please answer all questions.

  1. Name of Complainant

  2. ID Number (if any):                 3. Complainant Cell Phone  4. Complainant E-mail

  5. Please Select One. What is this complaint about?

     Curriculum Student Achievement Administrative Facilitues Equipment & Supplies Faculty Faculty Pronunciation Faculty Grammar Faculty Vocabulary Student Services Other Complaint Area. Describe Below.

  6. Other Complaint Area.  Please describe:

  7. Complaint Description (including staff or faculty member name)

  8.  Describe Complaint Resolution

  9.  Date of Resolution:          10. Name of Personnel Responsible:

11. Complainant Notification Date: