Student Concerns, Complaints, and Grievances

Background Information

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Your full name:

Your phone number:

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Please provide a phone number where we can reach you.

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

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Are you reporting a concern? Or filing a formal complaint? In which area of campus?

Date the issue began(Required):

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Involved Parties

Please list the involved individuals and offices/programs. Be sure to list yourself in this section.

Name of Individual or Organization

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UMN Student ID Number (if known)

Phone number (if known)

Email address (if known)

Factual Basis of the Concern or Complaint

Name of the program, office, or area of campus life where you are experiencing a concern or about which you are filing a complaint.(Required) This field is required.

Have you attempted to resolve the issue directly and informally?(Required)

Yes No

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If Yes, with whom? This field is required.

Describe the issue or action of concern. Please provide as many facts as possible, including all relevant dates and individuals involved.(Required) This field is required.

Please provide a proposal to remedy the situation.(Required) This field is required.

Supporting Documentation

If you have documents to submit related to your concern or complaint, please attached them here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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Background Information

Involved Parties

Factual Basis of the Concern or Complaint

Supporting Documentation

Submission