Student Dispute Resolution Form

Student Dispute Resolution Form

University of the Rockies // Resources // Student Dispute Resolution Center // Student Dispute Resolution Form

Student Dispute Resolution Form

Student Dispute Resolution Center Submission Form

Step I of the Dispute Resolution Procedure for Student Complaints encourages you to address your concerns first with the individual involved in the complaint (or the direct supervisor of that individual). If that does not provide satisfactory resolution or is impractical, please complete this form.

DO NOT USE THIS FORM FOR THE FOLLOWING: grade appeal, transfer credit appeal, appeal of academic dismissal, appeal of Student Community Standards findings, or to challenge course content or instructor performance. The Center does not have the authority to review these decisions, subject to exceptions described in the University Academic Catalog. Please follow the appropriate procedure for appeal of these concerns as outlined in the Academic Catalog (

Student, Alumni, Former Student, Prospective Applicant Information

Field with an asterisk * are required fields.

Subject of Complaint (check all that apply):

Complaint Information

Please provide the following information about your complaint:
Date & Time of Incident(s)

Please explain the nature of your complaint. (minimum 100 characters)
(Note: You will have the opportunity to submit documentation supporting your complaint after it has been reviewed.)

Please list the names of the individuals involved in your complaint:

Have you made an attempt to resolve this problem? If yes, please describe those attempts.

Please state the remedy you seek as the outcome of your complaint:

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