Home » Forms » Student Forms » Student Complaint Student Complaint Leave this field empty All fields are required; enter NA if not applicable. YES, I have attempted to resolve this complaint informally with the party/parties involved as outlined in the CTC Student Handbook. I AM: Current Student Prospective Student Former Student Other LOCATION: Central-Killeen Europe Fort Hood Pacific Far East (PFEC) Other Location COMPLAINT PERTAINS TO: Faculty Professor's First/Last Name: Course (e.g., ENGL 1301): Staff Other Student Department/Office Other: YOUR Information: First Name: Last Name: Student ID: Enrolled FROM: Enrolled TO: Street Address: City: State: ZIP Code: Enter at least one phone number (enter NA for others). Phone Number (Home): Phone Number (Cell): Phone Number (Work): Best Time to Call You: Email Address: COMPLAINT NARRATIVE/ALLEGATIONS (WHAT HAPPENED and WHEN?) State your complaint. Be as descriptive as possible; include specific information. * Date of incident * Names of all persons involved * Direct quotes of any conversation/s STEPS ALREADY TAKEN TO RESOLVE THE ISSUE (WHAT SPECIFIC STEPS HAVE YOU TAKEN TO DATE TO RESOLVE THE ISSUE?) What steps have you already taken to resolve the problem? * List names of people you have already spoken with * Include times/dates of conversation/s * Include direct quotes of any conversation/s DESIRED/EXPECTED COMPLAINT RESOLUTION (WHAT ACTION/S WOULD YOU LIKE TO OCCUR AS A RESULT OF YOUR SUBMITTING THIS COMPLAINT?) * State your desired/expected resolution. * Provide specific action/s you would like to occur as a result of filing this complaint. I understand that submission of this form serves as my signature and certify that the contents being submitted are true and accurate.