Student Complaint Form
* Indicates Required Field
Complainant Contact Information
* Last Name:
* First Name:
Middle Name:
* Street Address:
* City:
* State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Mexico
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
* Zip:
* Phone:
Area Code
Area Code
-
Prefix
-
Number
x
Extension
* Email:
* School Involved in Complaint:
Other School Name (input name below)
Bacone College
Cameron University
Carl Albert State College
Connors State College
East Central University
Eastern Oklahoma State College
Hillsdale Free Will Baptist College
Langston University
Mid-America Christian University
Murray State College
Northeastern Oklahoma A&M College
Northeastern State University
Northern Oklahoma College
Northwestern Oklahoma State University
Oklahoma Baptist University
Oklahoma Christian University
Oklahoma City Community College
Oklahoma City University
Oklahoma Panhandle State University
Oklahoma State University
Oklahoma State University - OKC
Oklahoma State University Institute of Technology
Oklahoma Wesleyan University
Oral Roberts University University
OSU Agriculture Experiment Station
OSU Agriculture Extension Division
OSU Center for Health Sciences
OSU School of Veterinary Medicine
OSU Tulsa
OU Health Sciences Center
OU Law Center
Phillips University
Redlands Community College
Rogers State University
Rose State College
Seminole State College
Southeastern Oklahoma State University
Southern Nazarene University
Southwestern Christian University
Southwestern Oklahoma State University
Southwestern Oklahoma State University - Sayre
Spartan School of Aeronautics
St. Gregory University
The University of Tulsa
Tulsa Community College
University of Central Oklahoma
University of Oklahoma
University of Science and Arts of Oklahoma
Western Oklahoma State College
Other School Name:
* Date of Last Attendance:
mm/dd/yyyy
Explain Outcome
Please explain the desired outcome you expect regarding your complaint.
* Desired Outcome:
Complaint Information
Have you followed the institutions appeals/or complaint process to resolve your complaints?
* Appeals/Complaint Process:
Yes
No
Note: the student must have exhausted the institution's complaint and/or appeal process before the OSRHE will attempt to help the student establish any possible resolution with the institution.
Explain the circumstances that led to your complaint. Be as specific as you can about your concerns and include all the information relevant to your complaint.
Complaint Circumstances:
Describe your efforts to resolve this complaint with the institution. Be as specific as you can, including dates, institutional staff with whom you spoke to regarding your complaint, and the school's response. Please include all information relevant to the complaint.
Resolution Efforts:
Have you filed this complaint with any other organization?
* Filed Complaint:
Yes
No
If complaint was filed, please identify the organization(s) and the outcome.
Explain Outcome:
Verification of Complaint and Consent
OSRHE will use the information you provide as part of its efforts to resolve your complaint. By submitting this complaint, you give consent to the OSRHE to contact the institution(s) on your behalf to gather information that may be needed to review your complaint. Your consent includes referring complaints to another organization with jurisdiction and authority over the issue.
By submitting this form, I agree that the information given in this complaint is true and accurate to the best of my knowledge, and I agree that I will provide any additional requested information or respond to questions from OSRHE related to the review of my complaint. I understand that if I fail to provide requested information or respond to questions, OSRHE may dismiss my complaint.
* Submission Agreement: