Nirmala Niketan

Application for Redressal of Grievance/s to CGRC

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Students having grievances of any nature, kindly fill up this form

* Marked fields are compulsory

Name of the Student *

Middle Name of the Student *

Last Name of the Student *

Department *

Email of the Student *

Faculty *

Residential Address of the Student *

Permanent Address of the Student

Mobile No. of the Student *

WhatsApp No. of the Student

Landline No. of the Student (if any)

Programme of Study *

If Other(Please Specify)

Class *

Year of Study *

Semester *

Roll.No. *

PRN No.

PG/PhD./M/Phil. Registration No.

(Add student Profile if more than one students applying for Redressal of Grievance/s)

Name of the Teachers/ Officers/ Staff/ Department against whom the complaint is to be lodged

List of Supporting Documents

Upload combined pdf file

Nature of the Grievance in which Redressal is sought

Or Upload pdf file

Declaration from the Student/s

I/We hereby declare that the above information furnished by me/us it true to the best of my/our knowledge. In case it is found false, I/we am/are personally responsible for the punishment.

Please enter captcha below.*

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Application for Redressal of Grievance/s to CGRC