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academic grievance form for graduate students

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8<br />

STEP FIVE<br />

Decision of the Chancellor (or designee):<br />

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Signature of the Chancellor: ____________________________ Date ______________________<br />

STUDENT ANSWER (Circle one, sign and date)<br />

[ ] I am satisfied with the answer to my <strong>grievance</strong>. Date ______________<br />

[ ] I am not satisfied with the answer to my <strong>grievance</strong> and wish to take it to the next step.<br />

Date ______________<br />

Additional sheets may be used as needed to explain the <strong>grievance</strong> and/or any decision.

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