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Grievance FORM

Student Grievance Form for Academic Accommodations

I certify that all the following are true:

I am a current or former student at EVCC.
I have exhausted all internal complaint or grievance options without acceptable outcome.
The issue, dispute, or incident involves academic accommodations under section 504 of the American with Disabilities Act as provided by EVCC and occurred within two (2) calendar years from the date of the alleged violations.
Indicate the approximate date and/or timeframe of the incident(s) or actions that led to this complaint (required):
Do one or more of the allegations listed below relate to the complaint?
The institution's academic accommodations provided to me under Section 504 of the American with Disabilities Act did not meet my requirements for equitable participation in the educational program.
Approximate Date informal complaint was filed with EVCC (if any):
Email of person at EVCC who handled the informal complaint (if known, or UNKNOWN):
Status of complaint:
Your Complaint:
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