Western Texas College

Complaint / Grievance Form

First Name:

Last Name:

Mailing Address:

City:

State:

Zip:

Email Address

When submitted, this form is sent to the Dean of Student Services.
The student will be notified within 5 day in regards to the length of time it will take to resolve the issue.

Please describe the nature of your complaint:

Please confirm that you are not a script by entering the letters from the image.

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