Student Complaint Appeal Form

Instructions: You must submit this appeal form within five business days from the date of the decision of your complaint.

*Required Field

Name: Name: First Middle Last
Your Tech Student Email Address:
Home Phone: Home Phone: - ### - ### ####

Please include the area code with your telephone number.
Mobile Phone: Mobile Phone: - ### - ### ####

Please include the area code with your telephone number.
Please describe your appeal in detail and restate the desired outcome (max 250 characters):
Type the letters you see in the image below.