Complaint Form – Curtin University Dubai

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Complaint Form

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Name *

First

Last

Gender *

Female
Male

Student ID *

Email *

Enter your Curtin Email address

Phone *

Complaint Details

Category concerned *

Campus Security
Careers Services
Financial Services
Grievance
Information and Communication Technology
Library Services
Staff behaviour
Student & Academic Services
Student behaviour
Student Council
Student Life
Student Success Centre
Teaching & Learning
Transportation Services
Visa Services
Others

Summary of your complaint

Please tell us

What happened
When it happened
Where it happened
Who was involved including their name(s), title(s), location and the nature of their relationship with you (student/advisor/external stakeholders)
Whether there were witnesses and who they were
Why you think it happened to you
Any other important details

At the end of this form, you can attach documents that you think might help us to assess your complaint.

Issue or complaint *

It is also helpful for us to know

How you have been affected by the situation
What you have done to try to resolve the matter ( E.g. Contact the person personally)

Details *

Please also tell us about the factors that have motivated you to lodge this complaint *

Please tell us about the outcome you are hoping for *

Attach additional documents/evidence here (Optional)

Click or drag a file to this area to upload.

Confirmation

I acknowledge that making a knowingly false or malicious notification is contrary to the Curtin Dubai Student Code of Conduct.
I certify that the details provided on this form are complete and accurate to the best of my knowledge
By submitting this complaint, I agree to the disclosure of the information provided to the appropriate decision maker. I understand that if my complaint is about someone’s behaviour, details of my complaint are likely to be provided to the person I have identified and to potential witnesses.

Declaration *

I have described the incident truthfully and accurately

Privacy Notice:
All the information provided in this form is private and confidential and only will be shared with the person (s) / parties that are related to the complaint for investigation purposes.

By submitting this form, I give my consent to Curtin University Dubai and its affiliates to utilise my data in accordance with its Privacy and Data Protection Policy.