Minerva Learning Centers Grievances Form
Student Name:
*
Student ID
*
Email Address
*
Phone
Course/ Program Enrolled
Year / Level of Study
Sem 01
Sem 02
Sem 03
Sem 04
Type of Grievance
Academic
Administrative
Staff Conduct
Discrimination
Facilities / Services
Others
If your choice in above question is "Others" please input below
Date of Incident
Location of Incident
Detailed Description of Grievance
Single choice
Any Attempts Made to Resolve the Issue?
If yes, please explain
Persons Involved (if any)
Upload Supporting Documents
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What outcome or resolution are you seeking?
I confirm that the above information is true and accurate to the best of my knowledge.
I confirm that the above information is true and accurate to the best of my knowledge.
Date of Submission of Grievance
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