Distance Education Complaint Form The Student Complaint Form is to be used to submit a formal concern regarding a distance education course or program when a student has been unable to satisfactorily resolve the issue with the faculty, staff, students or other involved parties.1 Please complete all fields so your complaint will be directed to the proper Institute officials. Complaints may be submitted anonymously; however, unless you include your contact information, MIT will be unable to investigate your complaint, inquire further or respond back to you regarding the subject matter. Contact Information Name (Last, First) * Email * Phone Course Complaint Information Concern * Please describe your concern in detail. Include the names of persons, issue, and dates involved. If this concern is against specific person(s), please list names and titles. Attempts * What attempts have you made to resolve this concern to date? Please state whom you contacted and what transpired. Other Information Any other information you want to provide? 1 MIT’s Distance Education Complaint Process is available here. Please review this page for additional guidance regarding the handling of student complaints for distance education.