Contact Details

Full Name 

Student Number 



Subject/Course Information



Subject Code 

Subject Name 

Lecture/Class Location 

Lecture/Class Time 

Name of Lecturer/Instructor/Tutor Concerned (if applicable) 


Report Details

Please select what type of concern you’re reporting:

 Teaching and Quality Issue

 COVID-19 Safety Issue

Please summarise your concern below:

Have you had any discussion with the teaching staff mentioned above about this issue?



If you have answered 'YES' to the above question, what was their response?

Has their response alleviated your concerns?



If you have not contacted the teaching staff or University administration about this issue, please let us know the reason for this:

Ideally, how would you like the University to resolve this issue?