(A) Printout the forms you have selected.  Answer all questions. Please print clearly.

(B) Please attach Original (not copies) of all relevant documentation to form(s). Examples of documentation to include are: contracts, payment receipts, credit card receipts or statements, canceled checks (front and back), sales slips, order blanks, and/or warranties.

(C) When describing your complaint, please explain all events in the order in which they occurred. Please provide dates whenever possible. Please state only the facts related to the complaint. If you need additional space, please use a separate sheet and attach it to your complaint.

(D) Return or mail the completed form(s) and documentation to:

Dr. Aquanette Simpson, Director
Room 210, Holmes Student Center
Northern Illinois University
DeKalb, IL 60115

(E) After we receive your complaint, we will notify you of receipt and if additional information is needed.

(F) If you have any further questions about how to file your complaint, please call: (815)753-1690

E-mail: eshrd@niu.edu