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Formal Complaint Form

This form is designed to provide students with an on-line method to file a formal complaint with Mesalands Community College.  Before completing this form, please review Mesalands Community College’s complaint procedures.

Students are strongly encouraged to resolve any concern by talking with the staff member, administrator, and his/her supervisor if necessary.
Assistance is available from the Vice President of Student Affairs.  Prompt reporting of all complaints is critical and necessary, as it is often difficult to trace the facts of an incident or incidents long after they have occurred. Students are advised that a concern or complaint will be most effectively addressed if the concern or complaint is brought forward within sixty (60) College working days of the alleged incident.  Students must complete each step in the process before proceeding to the next one.

A complaint is a request for the resolution of a problem, conflict, concern or issue that negatively impacts students, employees, the community and/or the College.  Student complaints may include (but are not limited to) issues regarding classroom instruction, College policies, procedures, services and offices.

Please note that reports related to Title IX should be made using the Title IX Reporting form, and concerning behavior that may not be a violation of Mesalands Community College’s student code of conduct should be reported using the CARE Team Reporting form.  Behavior that is a violation of Mesalands Community College’s code of conduct may be reported using Student Conduct Reporting form.

You are not required to complete the entire form in order for the complaint to be submitted.  The College’s ability to respond is improved based on the quantity and quality of information provided.

Background Information

If you wish to identify yourself, please fill in the information listed below.

If you are a third party complainant who is not the victim, include the victim.








Additional Party #1




Additional Party #2




Additional Party #3