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STUDENT GRIEVANCE FORM
STRICTLY CONFIDENTIAL
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CAMPUS
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GUINDY
KARAPAKKAM
PADUR
Full Name of Student as per School Records (in Block Letters)
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Your answer
Admission Number
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Your answer
Grade
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Your answer
Section
Your answer
Type of Complaint(Briefly explain)
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Your answer
Date of Incident
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MM
/
DD
/
YYYY
Approximate Time
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Your answer
Name of Staff Involved
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Your answer
Witnesses, if any
Your answer
Was there any earlier incident like this?
Your answer
If so, details thereof , staff involved including approximate date
Your answer
Have you brought this incident to any one’s notice, if so, details thereof
Your answer
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