Online System for Student Grievances 2024 In case of campus emergency, dial (412) 321-7550 or 911 Reporter's InformationName First Last PhoneEmail Nature of this reportAcademic GrievanceDiscrimination / HarassmentOtherDate of incident MM slash DD slash YYYY LocationOn-campusOff-campusOnlineInvolved Party #1Name First Last GenderMaleFemaleSelect RoleComplainantRespondentWitnessSupervisor of respondentReporting partyOther (describe below)Involved Party #2Name First Last GenderMaleFemaleSelect RoleComplainantRespondentWitnessSupervisor of respondentReporting partyOther (describe below)Involved Party #3Name First Last GenderMaleFemaleSelect RoleComplainantRespondentWitnessSupervisor of respondentReporting partyOther (describe below)Description and NarrativeAcademic Grievance Grade Degree N/A Harassment/Discrimination Sexual Racial / Ethnic Other N/A Complaint about Faculty Staff Dean / Manager Student Department Curriculum Policy / Procedure N/A Please provide a detailed description of the incident (you may also include attachments under "Supporting Documentation"):What resolutions are you seeking as a result of filing this report?Have you met with anyone regarding this issue? If so, please list who, when, and the outcome of that meeting.Support DocumentationPhotos, video, email, and other supporting documents may be attached below. (Up to 5 files, 32 MB maximum size each) Attachments require time to upload, so please be patient after submitting this form.File Drop files here or Select files Max. file size: 512 MB, Max. files: 5. Δ
