Complaint Form – Curtin University Dubai

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Name

First

Last

Gender

Female
Male

Student ID

Enter your Curtin Email address

Date of Birth

Phone

Contact details of Parents or location guardian if you are a minor

below the legal age of 18 years as of filling the complaint

Complaint Details

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

Witness Details Name and Student ID (if available)

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 understand that submitting a false or malicious report is a violation of the Curtin Dubai Student Code of Conduct. Such actions may lead to consequences, including but not limited to suspension, disciplinary action, or expulsion, as determined by the Disciplinary Committee at Curtin University Dubai.

Privacy Notice:
All information provided in this form is strictly private and confidential and will be handled in accordance with applicable data protection policies and laws. This information will be disclosed only to the individuals or parties directly involved in the complaint, and only to the extent necessary to obtain their statements. Additionally, information may be shared with various departments and officers of Curtin University Dubai for investigation purposes.

The University will not be bound to maintain confidentiality of any information if that information must be disclosed under any law or by a requirement of a regulatory body. Furthermore, the University is legally obligated to notify the parents or legal guardians of any parties involved who are under the age of 18.

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.