For more information, contact the Office of the Dean of Student Development, at (252) 246-1275
Instructions: Complete, print and sign this form. All fields are required.
Deliver it F-100 or mail to Dean of Student Development, Wilson Community College, P.O. Box 4305, Wilson, NC 27893.
Date/Time/Place of the incident/complaint
State formal complaint of grievance
(provide factual description of the compliant)
Describe the incident or concern
(give a timeline of events leading up to the
incident, list names of persons involved,
identify witnesses if appropriate):
How have you attempted to resolve this
situation or grievance?
What specific actions or suggestions do you
for resolving this concern/incident/complaint/grievance?