Suitemate Conflict – Complaint Form

If you are feeling threatened and/or require immediate attention please contact the Residence Office or Campus Security at 4444 or call 911

If you require assistant completing this form or would prefer to report in person please contact:

Residence Life Staff
Residence Office
Campus Security

This form will be treated as confidential and will be directly submitted to the Residence Manager/Residence Life Coordinator. This form will be used during the suitemate conflict resolution process to determine an outcome. All sections of this form must be completed. You will be contacted to arrange a meeting to discuss your complaint.

Full Name(required)

Email(required)

Student Number(required)

Campus(required)

4 Digit Bedroom Number(required)

Please list the resident(s) involved in this complaint(required)

Please summarize (be as specific as possible) the problem(s) you’re experiencing and highlight the area(s) of the Roommate Agreement that have been breached.(required)

Have you made an attempt to resolve your concerns? Please explain what actions you've taken(required)

I have attempted to speak to my suitemate(s) about this situation (required) Yes

I have spoken to my RA/SRA about this situation(required) Yes

A cleaning contract has been put in place for my suite (if applicable)(required) Yes

I have had a suitemate meetings facilitated by the Residence Life Coordinator/Residence Manager(required) Yes

Other (please specify)

What do you think is a reasonable resolution to this issue?(required)

I acknowledge that the statement made above are accurate, complete and true(required)