Name of the Student*
B.A.B.COM.B.B.A.(C.A.)/B.C.A.B.C.S./B.Sc.(CS).B.B.A.B. Sc – BT.M. Sc – BT.M.Sc. (CS) / M.C.S.M. Com.
Name of the Teacher/s / Officer/s / Staff / Section/s / Department/s against whom the Complaint is to be Lodged*
Grievance(Describe in detail)*
Supporting Documents(If Any)
Signature of the Student*