School of Arts and Sciences Student Complaint Form
Please complete this form to escalate academic matters to the Dean School of Arts and Sciences. As a reminder, the instructor, your academic advisor, then the department chair should be consulted prior to appealing to the Dean.
Note: You will be contacted by the telephone number provided on this form or your UAPB email address.
Type N/A for any item that is not applicable to your complaint.
1. First Name
2. Last Name
4. Telephone Number (Include Area Code) XXX-XXX-XXXX
5. Major
6. Classification
Please select...
Freshman
Sophomore
Junior
Senior
Graduate
Other
7. Anticipated Graduation Term (ex.Spring 2024)
8. Academic Department
9. Please Discuss your problem/concern
10. How can the Dean of the School of Arts and Sciences assist you?
11. If this is a class concern, did you consult the instructor? If yes, please proceed. If no, please follow the academic chain as provided in the instructions prior to submitting this form.
Yes
No
As a reminder, the instructor, your academic advisor, then the department chair should be consulted prior to appealing to the Dean.
12. Who is the instructor?
13. What is the name of the course(s)?
14.
What was the instructor's response?
15.
Have you consulted with your academic advisor? If yes, please proceed. If no, please follow the academic chain as provided in the instructions prior to submitting this form.
Yes
No
As a reminder, the instructor, your academic advisor, then the department chair should be consulted prior to appealing to the Dean.
16.
Who is your Academic Advisor?
17.
What was your Academic Advisor's response?
18. Have you consulted with the Department Chairperson? If yes, please proceed. If no, please follow the academic chain as provided in the instructions prior to submitting this form.
Yes
No
As a reminder, the instructor, your academic advisor, then the department chair should be consulted prior to appealing to the Dean.
19.
Who is the Department Chairperson?
20.
What was the Department Chairperson's response?
21.
Is there any additional information you would like to provide?
Contact Information
