Grievance

Staff/ Student*

Name*

Fathers Name*

Course/ Department

Class*

Enrolment No./ ID Number

Contact Number*

Email ID

Permanent Address*

Current Address*

Type of Grievance*

Date of incident/ problem*

PDF/JPG file attached facility*

Grievance Description*

Declaration from the Candidate

I hereby declare that the above information furnished by me is true to the best of my knowledge. In case if it is turned false I am personally responsible for the punishment.