State University System of Florida Board of Governors STUDENT

State University System of Florida

Board of Governors

325 West Gaines Street, Suite 1614

Tallahassee, FL 32399-0400

Website: www.flbog.edu

STUDENT COMPLAINT FORM

(For current, former, and prospective students)

Student Information

Full Name

Address

Phone

E-mail

Date of Birth

University Information

University

Location

Internal Policy

The Board of Governors’ internal policy is to respect the processes each university has

established to address student complaints and to require that students exhaust all

appropriate internal university processes before seeking an external review. However,

after a student has exhausted all internal university processes, provided there is no

avenue for external appellate review by a court, the Board’s complaint process provides

an avenue for review of those complaints in which a student asserts that the university

is not in compliance with state law or Board of Governors regulations. To that end, this

complaint form may be completed and submitted by those students asserting

noncompliance with state law or Board regulations.

Complaint Information

1. Have you followed the university’s established procedures to resolve your

complaint or concern? Yes No*

* If “No,” refer to the student handbook or contact the university student

ombudsman for information; then follow the university’s procedures to

resolve your complaint or concern.

2. Do you assert that the university is not in compliance with state law or Board of

Governors regulations? Yes* No

* If “yes,” please cite the statute or regulation for which you believe the

university is out of compliance. Statutes may be found at

http://www.leg.state.fl.us, and Board of Governors regulations at

http://www.flbog.edu/about/regulations/regulations.php.

Citation:

NOTE: If your complaint deals with noncompliance with a university board of

trustees’ regulation, please contact the ombudsman at the university, rather than

submit this form to the Board of Governors. Board of Trustees regulations are

located on the university’s Web site and on the Board of Governors’ Web site.

3. Describe your complaint in detail. Specify any pertinent dates, staff with whom

you dealt (including their e-mail and/or telephone contact information), etc. Attach

copies of any documentation which will help describe the problem and substantiate

your assertion that the university is out of compliance with state law or Board of

Governors regulations. Include any final letters of determination issued by the

university.

Submission

The information given in this complaint is true and accurate to the best of my

knowledge.

Name:

Date submitted:

Relationship to student*:

*Pursuant to 20 U.S.C. 1232g(d), a student attending a postsecondary institution has

privacy rights in his or her educational records under the federal Family Educational

Rights and Privacy Act. Accordingly, if this form is submitted by someone other than

the student, please attach a signed copy of the student’s consent form (a student consent

form may be obtained at the registrar’s office of the university). Absent student

consent, information contained in a student’s educational records maintained by a

postsecondary institution cannot be shared or discussed with anyone other than the

student.

Please save and email the completed form with appropriate attachments to

[email protected] or fax the completed form and attachments to 850-245-9685.