Student Concern Form (Confidential)

Student Concern Form
This form must be filled out completely and accurately, to the best of your ability.

THIS FORM WILL ONLY BE VIEWED BY KETTERING UNIVERSITY ONLINE ADMINISTRATORS.

YOUR INSTRUCTOR WILL NOT HAVE ACCESS TO THIS FORM OR INFORMATION CONTAINED HEREIN.
PLEASE NOTE: THIS FORM IS NOT TO BE USED FOR A GRADE APPEAL. IF YOU WISH TO APPEAL A GRADE, YOU MUST FOLLOW THE KETTERING UNIVERSITY GRADE APPEAL POLICY, WHICH CAN BE FOUND HERE.
Full Name*

First NameLast Name
E-mail*
Contact Number*
Course*
Please describe your concern.*
What, if anything, have you done to resolve this concern?*
What outcome are you seeking? Do you have a suggested remedy for the concern?
If you have any information you would like to submit for review, please upload.

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