Application for Redressal of Grievance/s to CGRC Order Number First Name of the Student : * Middle Name of the Student : * Last Name of the Student : * Department : * Email of the Student : * Faculty : * Select your Faculty Science and Technology Commerce Management 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 : Programme of Study : * Under Graduate Class : * Year of Study : * Select First Year Second Year Third Year Semester : * Select I Semester II Semester III Semester IV Semester V Semester VI Semester Roll No.: * PRN No.: Name of the Teacher/s / Officer/s / Staff / Section/s / Department/s against whom the Complaint is to be Lodged : * Nature of Grievance/s in which Redressal is Sought : 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 Place : *
