Philadelphia University + Thomas Jefferson University

Student Grievance Form

Student Information

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Grievance Category

 


Describe the Issue

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Description of Grievance *


If Policy Violation or Request for an Exception to Policy please indicate the policy here.


 
 Yes
 No


Is there any supporting information available?
For example, regarding your grievance, documents, etc?


Please indicate what steps you have taken to address your grievance. 
Check all that apply.

 None taken
 Met with person closest to the issue
 Met with other department member(s) to address the issue
 Have been referred to fill out this form
 

What do you feel is an appropriate outcome to this grievance?*



By my e-signature I verify this information to be accurate to the best of my knowledge.

 

   

Hours
Mondays - Fridays
8am - 5pm  


Edison Building
Suite 1120
(215) 503-6335
(215) 503-2787

 

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