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Whitlowe R. Green College of Education

Candidate Inquiry/ Complaint Form

1.
Date
2.
Personal Information
First Name
Last Name
Permanent Home Address
City
ST
Zip
Phone Number
Email
Department / Office
3.
Current Mailing Address (if different from above):
StreetCity
STZip
Primary PhoneAlternate Phone
Email
4.How would you prefer we contact you?
5.
Inquiry / Complaint Details
The information you provide will be used in efforts to resolve your inquiry/complaint and will be shared with the school. By submitting this complaint, you are giving the Prairie View A&M University Whitlowe R. Green College of Education permission to contact individuals to discuss a possible resolution to your inquiry/complaint.
Describe your inquiry/complaint in detail? Specify any pertinent dates, staff you dealt with, etc.

Attach any documentation which will help describe the problem and substantiate you allegations. (i.e. emails correspondences, forms, etc.)