A Better CPTC: Academic Concern
Academic Concerns related information
Type of Concern
---- Select Concern ----
Exception to Class/Program Policies
General Classroom Management
Grade Appeal
Unfair Treatment
Other
Describe Concern
Date Occurred
Time Occurred
-Hours-
1
2
3
4
5
6
7
8
9
10
11
12
-Minutes-
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
-AM/PM-
AM
PM
Location
Previous Steps
CPTC Program
Choose a Selection
Other / Undecided
Accounting
Architectural Eng Design
Auto Collision Tech
Auto Restoration
Auto Upholstery/Glass
Automotive Technician
Aviation Maintenance
BAS - C
BAS - ID
BAS - META
BAS - OP
Central Srv Sterile Proc
Computer Programming
Construction-Residential
Cosmetology
Culinary Arts
Dental Assistant
Digital Entertainment
Early Care & Education
Electrician Low Volt/Fire
Environmental Sciences
Esthetic Sciences
Graphic Technologies
Health Unit Coordinator
Heat/Air Cond Tech
Hemodialysis Tech
Histology Technician
Human Services
Interior Design
Manufacturing Engineering
Massage Studies
Mechatronics
Medical Assistant
Medical Lab Technician
Network Ops & Sys Sec
Nondestructive Testing
Nursing - LPN
Nursing Assistant
Pastry Arts
Pharmacy Technician
Pre Nursing
Professional Pilot
Restaurant Operations Mgt
RETAIL BUS MRKTG/MGT
RN Option
Surgical Technician
Sustainable Building
Upholstery
Welding Technology
Enter the names of any individuals you suspect were involved or witnessed the behavior
Full Name 1
Full Name 3
Full Name 2
Full Name 4
Occurred Before
-- Select Value --
Yes
No
Reported to CPTC
-- Select Value --
Yes
No
Relationship to CPTC
-- Select Value --
Employee
Student
Faculty
Parent
Business Vendor
Other
Select the best method to contact you and provide contact information
Your Full Name
Please Call
Phone Number
-- When "Please Call" is selected a number is required --
Please Email
Email Address
-- When "Please Email" is selected your email address is required --
Create a password to login and access the current status of this concern
Your Password
Attach File 1
Attach File 2
I understand Clover Park Technical College will use the information I have provided to assist with investigating and resolving my complaint. I consent to Clover Park Technical College’s disclosure of any protected or confidential information that may be needed to review and investigate this complaint. I hereby declare that the information on this form is true, correct, and complete to the best of my knowledge. I understand that any misrepresentation of information may result in disciplinary actions, in accordance with college disciplinary polices.
I have read and accept the above
