Student Complaints Procedure (QPROSC) – Complaint Form

Instructions:

This form should be completed in conjunction with the requirements of the Student Complaints Procedure (https://www.tcd.ie/about/policies).

Complete all sections of the form.

Return completed form to: fscp@tcd.ie

Section 1: Personal details

1.1	Student number	Click here to enter text.
1.2	Student name	Click here to enter text.
1.3	TCD email address	Click here to enter text.
1.4	Contact number	Click here to enter text.
1.5	Term address	Click here to enter text.
1.6	Course title	Click here to enter text.
1.7	Year of course	Click here to enter text.

Section 2: Details of complaint

2.1	Area of college against which complaint being made:

Area
Student Services	Choose an item.
Core Services	Choose an item.
Faculty
- School
Other	Please specify the area

2.2	Date of incident	Click here to enter a date.

(Note: If the event happened over a period of time, please insert the start date of the incident)

2.3	Please provide a summary of your complaint below (max 1250 chars)

Please provide a summary of your complaint below (max 1250 chars)

2.4	In an attempt to resolve my complaint locally I have already communicated with the following people.

Please provide a list of the people with whom you have communicated (and the dates this occured).

2.5	This is what happened and why I believe it did not resolve my complaint (max 1250 chars.)

Please provide a summary (max 1250 chars)

2.6	Please explain the impact of the issue on you (max 1250 chars.)

Please explain the impact (max 1250 chars)

2.7	If you are submitting a complaint more than one month following the last related incident please provide a brief explanation for the delay (max 1250 chars.)

If applicable, please provide a brief explanation for the delay (max 1250 chars)

By submitting this form, I confirm that I have read the Students Complaints Procedure and have attempted to resolve the matter locally (please check the box)	☐