ࡱ> nsmwk  bjbjȬ 7^΢,j΢,jEN N 8-|:"- vp$W:Y:Y:Y:Y:Y:Y:<?Y:Y:n:FW:W:}5f[8D,Jv6C::0:6^"@d"@4[8"@[8Y:Y::"@N Y : QUEENS UNIVERSITY BELFAST STAGE 2 - STUDENT COMPLAINTS FORM IMPORTANT PLEASE READ THIS SECTION CAREFULLYPlease read the HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/GeneralRegulations/AppealsConductandComplaints/StudentComplaints/StudentComplaintsRegulations/"Student Complaints Regulations and HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/GeneralRegulations/AppealsConductandComplaints/StudentComplaints/StudentComplaintsProcedure/"Student Complaints Procedure before completing this form. Supporting guidance is also available HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/AppealsComplaintsandMisconduct/StudentComplaints/"online. Students can only have a matter considered under one procedure. If you have also submitted an academic appeal in relation to this matter, the Director of Education and Student Services (or nominee) and a senior colleague will decide which Regulations should apply. Every effort will be made to ensure confidentiality, consistent with a full investigation of the complaint. Complaints made anonymously will not be accepted. You must: Complete all sections of this form fully. Select the ground(s) on which you are appealing. Attach the evidence in support of your complaint and list where indicated. Evidence submitted after the deadline may not be considered. Witnesses should submit their statements via the HYPERLINK "https://forms.office.com/Pages/ResponsePage.aspx?id=6ner6qW040mh6NbdI6HyhsxB9YWHxklFjqHcF2OgVt9UMEQwQzk4S0dGNlo5WkdSMjA5OFUwSDVMTyQlQCN0PWcu"Witness Statement Form. Submit this form within ten working days of the informal (Stage 1) Outcome. Send the completed form to the Appeals, Conduct and Complaints Team HYPERLINK "mailto:appeals@qub.ac.uk"appeals@qub.ac.uk. You are strongly encouraged to seek advice and guidance from HYPERLINK "http://www.qubsu.org/AdviceSU/Academic/"SU Advice. Support is also available from the  HYPERLINK "/directorates/sgc/wellbeing/" Student Wellbeing Service. Section 1: Your details Full Name: Student Number: Email: School:  Section 2: Informal Action Taken Have you attempted to resolve your complaint informally (via Stage 1 of the Student Complaints Procedure)? Yes/No If no: Please provide explanation (and any supporting evidence) as to why you are not able to seek an informal resolution of your complaint. If yes: Please provide a summary of any informal action (Stage 1) you took to resolve your complaint, with supporting evidence if this is available. Section 3: Details of your complaint Please provide details of your complaint and the impact this has had upon you. Please ensure all relevant details are provided, e.g. the identities of witnesses and the date, time and location of the incident(s) giving rise to the complaint. If you have attempted to resolve this informally (Stage 1), you must explain which parts of your complaint were not adequately addressed at Stage 1.  Section 4 Supporting evidence Please list all of the evidence and documentation attached in support of your complaint. Please refer to the Evidence for Student Complaints Guidance published HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/AppealsComplaintsandMisconduct/StudentComplaints/"online.  Section 5 - Desired outcome. Please outline the outcome that you are seeking. Please note that the Student Complaints Regulations cannot be used to challenge academic judgment or to complain about the outcome of another University Procedure.  Section 6 - Declaration By signing this form, you are declaring that: you have read and understood the HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/GeneralRegulations/AppealsConductandComplaints/StudentComplaints/StudentComplaintsRegulations/"Student Complaints Regulations and HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/GeneralRegulations/AppealsConductandComplaints/StudentComplaints/StudentComplaintsProcedure/"Procedure; to the best of your knowledge, this form contains a complete and accurate account of all the factors relevant to your complaint; you understand that a copy of this form may be provided to a member of staff who is the subject of the complaint (if relevant), or who is otherwise involved; you consent to this information and supporting evidence being disclosed to the members of staff involved in the Student Complaints Regulations and Procedure; any witnesses listed are aware that you have identified them as witnesses, and have consented to the sharing of any witness statements with the University; and you are aware that making a complaint which is found to be frivolous or vexatious may be deemed to be a breach of the HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/GeneralRegulations/ConductRegulations/"Conduct Regulations. Provided that the information has not already been disclosed as set out above, if you wish to withdraw consent to any information being disclosed, or if you wish to withdraw your complaint in its entirety, you may do so at any time by sending an email to  HYPERLINK "mailto:appeals@qub.ac.uk" appeals@qub.ac.uk. 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