Latha Mathavan Logo

Grievance Form

Please fill all the field's in the form in 'CAPITAL LETTER'

Personal Details
Name:
ex:XXXXXXX .X
Gender:
ex:M / F
Date Of Birth:
ex:mm/dd/yyyy
Mobile no:
ex:9876543210
Mail Id:
ex:xxxxxxxx@gmail.com
Designation:
ex:Student / Tech-Staff / Non-Tech-Staff



Educational Details
Degree:
ex:Dip or BE or BSc (or else put NIL)
Course:
ex: CSE or IT (or else put NIL)
Reg No:
ex:A952633255(or else put 0)
College Name:
ex:LMEC or LMPC or LMASC (or else put NIL)



Grievance Details
Comments: