USC Upstate School of Education
Student Grievance/Concern Form

This form is to be completed by a student who has a legitimate grievance or concern and does not wish at this time to invoke the Student Grievance Policy as noted in the USC Upstate Student Handbook.  A copy of this form will be electronically sent to Dr. Jim Charles, Interim Dean- School of Education.  He will respond to this matter as soon as possible.  Please ensure that your contact information is entered correctly to expedite a response. 

Date:    [None] Select a Date Delete the Date   
First Name:  
Last Name:  
Upstate Email:  
Phone:  

In detail, describe the matter about which you are concerned using professional narrative.  Please include the date and setting of the occurrence.