Complainant Information All fields are required. Please note that the Coordinating Commission for Postsecondary Education cannot act on anonymous complaints. First Name of complainant: Last Name of complainant: Affiliation with the college or university named below: Current student Former student Parent or guardian of current/former student (for students under 19) Other Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas (AA) Armed Forces Europe (AE) Armed Forces Pacific (AP) Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Québec Saskatchewan Yukon Zip Code: Preferred Phone Number: Email Address: How do you prefer to be contacted: Phone Email No preference If Commission staff members need to contact you via phone, may they leave a phone message or voicemail? Yes – staff may leave a phone message or voicemail No – staff may not leave a phone message or voicemail College/University Information Name of institution: City located: State located: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas (AA) Armed Forces Europe (AE) Armed Forces Pacific (AP) Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Québec Saskatchewan Yukon Degree level and major/concentration (e.g. B.S. in Accounting; Certificate in Welding) of the affected student: Dates of attendance at institution: Start Date: End Date: Complaint Information Have you gone through the institution's formal complaint process? Yes – I have gone through the institution's formal complaint process No – I have not gone through the institution's formal complaint process If you answered "Yes", please submit documentation showing that you have exhausted your appeals at the institutional level. Please see below on how to send in such documents. If you answered "No", please explain in your detailed complaint description below why you were unable to complete the complaint process. Note that the Commission will normally only address complaints after a student has exhausted his/her appeals at the college or university level. Please describe your complaint in detail, including the names of any college or university faculty or staff you spoke to about the complaint: Please give titles and contact information for the individuals (if any) you mentioned above: How would you like your complaint to be addressed? (Please note that the Commission cannot, by law, review complaints related to course grades, academic sanctions or discipline/conduct matters.) Will you be submitting additional documentation (such as e-mails from school officials, transcripts, course syllabi, contracts, brochures, catalogs and/or tuition bills) that substantiates your complaint? Yes – I will be submitting additional documentation No – I will not be submitting additional documentation Please send copies of any documents that support your above complaint and/or show that you have gone through your institution's complaint procedure to: Kathleen.Fimple@Nebraska.gov, fax them to (402) 471-2886, upload files below, or mail them to: Nebraska Coordinating Commission for Postsecondary Education ATTN: Complaints P.O. Box 95005 Lincoln, NE 68509-5005 By submitting this form, I affirm that I am a current or former student of the institution named above or the parent or guardian of a current or former student of that institution who is currently under age 19 and/or under my legal guardianship. I agree to allow the Coordinating Commission for Postsecondary Education to submit a copy of my complaint and supporting materials to the above-named institution for a response, as well as to the state agency responsible for complaints in the state in which the institution is located or in which I live if not Nebraska. I further authorize the institution to transmit student records related to me or to the individual(s) under my guardianship affected by the institution's actions to the Commission for review. I understand that I may have to submit an information release form to the institution. Additionally, I recognize that my complaint may be subject to Nebraska's public records law as defined in Nebraska Revised Statutes §§ 84-712 through 84-712.09. I certify that the information I have provided to the Commission is complete, true, and correct to the best of my knowledge and belief. Upload documents below: Total file size for all files cannot exceed 17MB. File Upload 1 of 2 (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt) File Upload 2 of 2 (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt)
