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Program Integrity Student Complaint Form

Use this form only if you have a concern or complaint related to an institution's accreditation or a violation of Tennessee law.

Complaint Category *

Complainant Information

First Name *

Middle Initial

Last Name *

Address

City

State

Zip Code

Country

Daytime Phone

Email Address *

Current student status (if applicable)

I am currently... *

Complaint Details

Institution involved *

Date complaint originally filed with institution

Month

Day

Year

Provide the details of your complaint including the events that led to this complaint and how the institution has violated specific sections of the Principles of Accreditation or State law *

Describe how you have already attempted to resolve your complaint with the school - including the outcome of that attempt *

Explain how you would like to see the issue resolved *

Have you filed an official complaint with any organization? *

List the organization's name and the outcome of the complaint below

Have you contacted an attorney about this complaint? *

What court action have you taken?

Certification

By including my name and email address here, I hereby certify that I am the named complainant and that the above statements are true. I understand that this complaint and the information provided will be shared with the institution.

Your First Name *

Your Last Name *

Email Address *

Today's Date *

Month

Day

Year

Leave this field blank

Read more about Program Integrity Student Complaint Form

Fraud, Waste, and Abuse Reporting Form

For more information about reporting fraud, waste and abuse, please visit the "Fraud, waste, and abuse" section.

Institution Involved *

In your own words, please describe the who, what, when, where and how of the fraud, waste or abuse *

Name(s), job title(s), department(s) of the individual(s) involved

Date of occurrence

Month

Day

Year

Time of occurrence

Hour

:

Minute

am

pm

Describe how and when you became aware of the problem being reported

If you have reported your concern to any other department, school or agency, to whom did you report your concern

If you wish to remain anonymous, you do not have to provide contact information. We encourage you to provide your contact information for any follow-up questions that may arise during our review or to obtain a copy of the final report at the completion of the review. All contact information provided is considered confidential under TCA 8-50-116. However, if TBR or one of its institutions has a separate legal obligation to investigate the complaint (e.g., complaints of illegal harassment or discrimination), TBR and its institutions cannot guarantee anonymity or complete confidentiality.

Your First Name

Your Last Name

Your Work Phone Number

Alternate Phone Number

Email Address

If there are other individuals aware of this problem who could provide more information, provide their full names and contact information

Do you have documents to attach?

Attachments

Attachment

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx.

Attachment 2

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt pptx xls xlsx.

Attachment 3

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt pptx xls xlsx.

Attachment 4

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt pptx xls xlsx.

Attachment 5

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt pptx xls xlsx.

Leave this field blank

Read more about Fraud, Waste, and Abuse Reporting Form

TCAT Shelbyville

The Tennessee College of Applied Technology - Shelbyville is a modern training facility designed to simulate the occupational environment found in potential places of employment. The controlling purpose of the training offered is to prepare individuals for useful and gainful occupations, thereby enhancing their potential for employment.