This form is to be used to submit a grievance in which you have been unable to satisfactorily resolve with the faculty, staff, students, or others involved. Please complete all fields so your grievance can be reviewed.

For Civil Rights grievances (including race- and gender-based discrimination), contact:
Lindsey Garza
civilrights@rellis.tamus.edu
979.317.3404

I am.... * Please indicate your relationship to the RELLIS Campus.

Incident/Grievance Type * Please select the report type which represents the issue you are submitting.

First Name *

Last Name *

Email *

Phone xxxxxxxxxx

Date/Time Frame of Incident * Please provide the approximate date or time frame that this incident occurred. If this is not known, indicate when you were first made aware of the concern. *Ex: MM/DD/YYYY or Term YYYY

Time of Incident If applicable, indicate the time the incident occurred. Ex: HH:MM PM

Incident Location *

Incident Description * Please provide as much information as possible (there is a 32,000 character limit).

Additional Parties Involved Please list the names (and ID numbers if possible) of all persons and/or groups that were involved in this incident.

Institution * Select all institutions in which you are affiliated.

Comments

This form is to be used to submit a grievance in which you have been unable to satisfactorily resolve with the faculty, staff, students, or others involved. Please complete all fields so your grievance can be reviewed.

For Civil Rights grievances (including race- and gender-based discrimination), contact: Lindsey Garza civilrights@rellis.tamus.edu 979.317.3404

For Civil Rights grievances (including race- and gender-based discrimination), contact:
Lindsey Garza
civilrights@rellis.tamus.edu
979.317.3404