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Student Complaint Form
Please complete the following form.
Date event occurred *
Student's first name *
Student's last name *
CNM Student ID No. *
Check one *



Course Name and Course Number
*
Name of Instructor *
Identify the category of your complaint (check all that apply)  
*




Describe the issue or concern (be specific regarging who, what, when, and where)  
*
Have you talked with staff or the instructor regarding your concern? (if yes, please describe the outcome)
*
Student contact information
Street address *
City *
State *
Zip code *
Phone *
my CNM Email Address *
When address my concern (check one)
*


How did you find out about this process?
*
Today's date *
 
Please PRINT THIS FORM before pressing the Submit button as confirmation
 

CNM will not allow any form of retaliation against individuals who file a complaint to CNM management, or who cooperate in the investigation of such reports. To the extent possible, the confidentiality of the reports will be maintained.