Bath Spa University

Full name:*

Student Enrolment No: (where applicable):

Address for correspondence in connection with the complaint:*

Postcode:*

Telephone Number:*

Email Address:*

Outline of Complaint, including dates of actions:*

As part of the investigation of your complaint. any member of staff mentioned will be made aware of the complaint.

Please explain here what steps you have taken, together with dates, to resolve your complaint:*

Please indicate, without prejudice, what outcome or further action you are expecting:*

If you have written a formal letter of complaint to anyone else in the University please indicate names and /or let us know whether you intent to copy this to anyone else:

Declaration

I declare that the information given in this form is true, and that I would be willing to answer further questions relating to it if necessary.

Please tick to confirm you have read the declaration