Student Organization Complaint Form

Name of student organization that is the subject of your complaint:

Describe the alleged violation:

When did this occur? :

Where did it occur? :

How was identification of the group determined:

Name of individuals present and/or involved with the above incident:

Name of witnesses or other individuals with first-hand knowledge:

Which entity sponsored the event? (University student fees, outside sponsor, etc.):

Did you file this complaint with any other entity? (Public Safety, Campus Security, other campus affiliate, organization's advisor?) Please identify. :

First name:

Last name:

Street Address:

City:

State:

Zip:

Phone:

Organization: