Faculty Affairs- Complaint Form
Revised 8/23/2023
Page 1 of 3
Complaint Form for Faculty Members, Students, Staff Members, and
Third Parties Against a Faculty Member or Faculty Administrator
Privacy Notice: State law requires that you be informed that you are entitled to: (1) request information collected
about yourself on this form (with a few exceptions as provided by law); (2) receive and review that information; and
(3) have the information corrected at no charge. To request this information, contact https://openrecords.tamu.edu/
or phone 979.862.4571.
INSTRUCTIONS Please complete the following steps before submission:
1. Provide your information.
2. Complete the Identification of Witness section.
3. Save, print, and sign your name.
4. Submit your completed packet form and any relevant documentation to fa-
grievances@tamu.edu.
The information you provide will be used by Texas A&M University following the procedures
and timeframes referenced in SAP 12.99.99.M0.01 Faculty Affairs is available to provide
Today’s date
Name (Complainant)
Status (Faculty, staff, student, other)
UIN
Title
Department
School/College
Phone number
Email address
Date of hire
Date of action or incident that led to this complaint
1. What is the subject/nature of your complaint?
2. Did you discuss this complaint with the appropriate academic leadership to initiate
resolution? If so, on what date(s)? Please include their name(s) and title(s).
Faculty Affairs- Complaint Form
Revised 8/23/2023
Page 2 of 3
INSTRUCTIONS
Provide firsthand information describing your complaint. Also, provide or list any evidence that
would suppor
t your position and assist Faculty Affairs with the assessment and process of your
complaint.
Please attach any relevant documentation.
By my signature, I certify that the facts submitted by me are true and accurate to the best of my
knowledge.
(Complainant’s Signature) (Date)
3. Who is your complaint against (respondent(s))? Please include their name and title.
Faculty Affairs- Complaint Form
Revised 8/23/2023
Page 3 of 3
Identification of Witnesses Section
INSTRUCTIONS
Please provide the name
s of witnesses with firsthand knowledge of information directly
related to your complaint.
Name and Title of Witness
Phone Number
Email Address
Issues for which the witness will have firsthand knowledge:
Name and Title of Witness
Phone Number
Email Address
Issues for which the witness will have firsthand knowledge:
Name and Title of Witness
Phone Number
Email Address
Issues for which the witness will have firsthand knowledge:
INSTRUCTIONS TO SUBMIT
You MUST submit forms via
fa-grievances@tamu.edu
Please attach any relevant documentation with this form.
NEED HELP?
Faculty Affairs
979.845-4284
fa-grievances@tamu.edu
Office Use Only:
Date Received: Time Received: Received By:
