NAME

SELECT ROLE Student Faculty Non-Teaching Staff

ROLL NUMBER / FACULTY ID / STAFF ID

DEPARTMENT CIVIL ENGINEERING COMPUTER SCIENCE & ENGINEERING ELECTRONICS & COMMUNICATION ENGINEERING ELECTRICAL & ELECTRONICS ENGINEERING INFORMATION TECHNOLOGY MECHANICAL ENGINEERING SCIENCE & HUMANITIES OFFICE / OTHER

YEAR OF STUDY FIRST YEAR SECOND YEAR THIRD YEAR FINAL YEAR

E-MAIL ADDRESS

MOBILE NUMBER

GRIEVANCE TYPE Women Grievance / Sexual Harassment Related Ragging Related Infrastructure Related Faculty Related Hostel Related Examination Related Other

GRIEVANCE

SUBMIT GRIEVANCE

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