Student Grievance Date of Complaint* Name of the complainant* Semester* Department * Name Designation and Dept. of the person(s) against whom the complaint to be lodged * Email of the complainant* Contact Number of the complainant * Subject* Description of each incidents of alleged harassment with date time and location.* Name the person (s) witnesses with Department Are there others who have witnessed/ experienced the alleged behavior of the individuals named above? If so, indicate names of such persons with nature of harassment witnessed/ experienced * Did you tell anyone about the experience after the alleged incident(s)? If so, please provide their names *
