Women Grievance Complaint Form(Anonymous)

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Any women grievance can be complained without revealing your identity

Name of the Complaint

Who are you?? *

Student

Staff

If Student ,Year you belongs to *

IV/IV

III/IV

II/IV

I/IV

Branch you belong to *

If staff branch you belong to? *

Designation *

Nature of the complaint *

Ragging

Sexual Harassment

Eve teasing

Theft

Lack of Facilities

Any other

Assailant/Attacker/Assaulter *

Student

Staff

Outsider

Any other

Branch of Attacker *

Is the attacker single? *

Yes

Assaulter belongs to *

Male

Female

Any action took against the assaulter previously? *

Yes

What do you want us to do? *

Want to communicate with You

Not want to communicate with you

Submit

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