Read the following before signing.
I hereby declare that the above statements are true to the best of my knowledge. I understand that any false
statements made in this complaint/grievance may be subject to a Student Code of Conduct violation.
My signature below indicates that I have followed the Grievance Procedure as set forth in the University of
Indianapolis Student Handbook and that I seek redress regarding the concern I have formally documented.
I understand and give my consent to share need to know information within the institution in a confidential
manner and in the event the complaint/grievance rises to an external process, with external agencies.