Student Complaint Form

Directions: Please complete and sign this form online. While it is our preference that this form be submitted through the online form, we also want to present the option of submitting a hard copy. If you would prefer to submit a hard copy, then please print, complete and return to the Office of the Registrar.

The University of North Carolina at Pembroke is committed to addressing student complaints. In accordance with UNC Pembroke Student Grievance Policy on the informal resolution of student
grievances, students are encouraged to discuss their complaints directly with the person responsible. If the issue is not or cannot be resolved through discussion with the responsible person, then the
student should complete this form and submit it to department chair or supervisor of the person against whom the complaint is to be made. Every effort will be made to respond to the complaint in
an appropriate manner.

Students should consult the following policies for specific complaint procedures pertaining to these areas:

Academic Honor Code
Code of Conduct
Student Grievance Policy
Policy Prohibiting Illegal Harassment and Discrimination
Student Grievance Policy for Students with Disabilities
Sexual Harassment Policy
Sexual Assault Policy
Inspection and Release of Student Records
Undergraduate Grade Appeals Process
Suspension Appeals
Residency Appeals
Financial Aid Appeals

Would you like to use your UNCP ID or Last 4 digits of SSN?

UNCP ID

Last 4 digits of SSN

UNCP ID

Last 4 of SSN

Student Information

Last Name

First Name

Middle Initial(s)

Suffix

Home Phone

Cell Phone

Address

City/Town

State/Province

ZIP/Postal Code

Country

Your Complaint

What have you done to resolve your complaint?

Remedy

Signature

Sign above

Date 07-13-20

Downloads

Student Complaint Form - (Revised: 01-09-2014)