Name of the Student

Registration No.

Your email

Your Mobile No.

Gender
MaleFemale

Department
B.TechM.TechB.PharmaD.PharmaB.ComM.ComB.B.A.M.B.A.

Year
First YearSecond YearPre-Final YearFinal Year

Grievance Column

In the space below, state your grievance. Be as specific as possible. If this is an academic grievance (including a grade appeal), please give the faculty’s name, and department.

Respondent

Please indicate the type of grievance
AcademicNon-Academic