{"id":5,"date":"2019-04-01T06:25:11","date_gmt":"2019-04-01T06:25:11","guid":{"rendered":"http:\/\/nadiadayurveda.org\/feedback\/?page_id=5"},"modified":"2019-04-11T11:58:40","modified_gmt":"2019-04-11T11:58:40","slug":"grievance-form-for-students","status":"publish","type":"page","link":"https:\/\/nadiadayurveda.org\/feedback_form\/grievance-form-for-students\/","title":{"rendered":"GRIEVANCE FORM FOR STUDENTS"},"content":{"rendered":"\t\t<div data-elementor-type=\"post\" data-elementor-id=\"5\" class=\"elementor elementor-5\" data-elementor-settings=\"[]\">\n\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-element elementor-element-38831420 elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-section elementor-top-section\" data-id=\"38831420\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3ae6b788 elementor-column elementor-col-100 elementor-top-column\" data-id=\"3ae6b788\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-74ec69b8 elementor-widget elementor-widget-shortcode\" data-id=\"74ec69b8\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f10-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/feedback_form\/wp-json\/wp\/v2\/pages\/5#wpcf7-f10-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"10\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.4.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f10-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"container feedback_form\"> <img src=\"http:\/\/nadiadayurveda.org\/feedback_form\/wp-content\/uploads\/2019\/04\/nadiadayurveda-header.png\" class=\"img-responsive header_banner\" \/><\/p>\n<div class=\"row\">\n<div class=\"col-md-12\">\n<h3 class=\"feedback_title\">GRIEVANCE FORM FOR STUDENTS<\/h3>\n<\/div>\n<div class=\"col-md-2\">\n      <label> Roll Number<\/label><br \/>\n      <span class=\"wpcf7-form-control-wrap roll_no\"><input type=\"text\" name=\"roll_no\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/div>\n<div class=\"col-md-2\">\n      <label> Name of Student<\/label><br \/>\n      <span class=\"wpcf7-form-control-wrap name_of_student\"><input type=\"text\" name=\"name_of_student\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/div>\n<div class=\"col-md-2\">\n      <label> Student Email <\/label><br \/>\n      <span class=\"wpcf7-form-control-wrap student_email\"><input type=\"email\" name=\"student_email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/div>\n<div class=\"col-md-2\">\n      <label> Course<br \/>\n       <span class=\"wpcf7-form-control-wrap professional_course\"><select name=\"professional_course\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"UG\">UG<\/option><option value=\"PG\">PG<\/option><\/select><\/span><br \/>\n <\/label>\n    <\/div>\n<div class=\"col-md-2\">\n      <label> Mobile number<br \/>\n        <span class=\"wpcf7-form-control-wrap mobile_number\"><input type=\"text\" name=\"mobile_number\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label>\n    <\/div>\n<div class=\"col-md-1\">\n      <label> Year<br \/>\n       <span class=\"wpcf7-form-control-wrap term_year\"><select name=\"term_year\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"First\">First<\/option><option value=\"Second\">Second<\/option><option value=\"Third\">Third<\/option><option value=\"Fourth\">Fourth<\/option><option value=\"Intern\">Intern<\/option><\/select><\/span><\/p>\n<p> <\/label>\n    <\/div>\n<div class=\"col-md-12\">\n<p>Please tick mark in appropriate box. <\/p>\n<\/div>\n<div class=\"col-md-12\">\n<table class=\"table\">\n<tr>\n<td width=\"16\">1<\/td>\n<td width=\"202\">Select any one<\/td>\n<td width=\"287\">\n<span class=\"wpcf7-form-control-wrap type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"type\" value=\"Administration\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Administration<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"type\" value=\"Staff (Teaching and Non-teaching)\" \/><span class=\"wpcf7-list-item-label\">Staff (Teaching and Non-teaching)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"type\" value=\"Department\" \/><span class=\"wpcf7-list-item-label\">Department<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"type\" value=\"Student\" \/><span class=\"wpcf7-list-item-label\">Student<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"type\" value=\"Curricular activity\" \/><span class=\"wpcf7-list-item-label\">Curricular activity<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"type\" value=\"Examination\" \/><span class=\"wpcf7-list-item-label\">Examination<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"type\" value=\"Extracurricular activity\" \/><span class=\"wpcf7-list-item-label\">Extracurricular activity<\/span><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td>2<\/td>\n<td>Name of individual and \/ or department against<br \/>\nwhom the grievance is filed:<\/td>\n<td><span class=\"wpcf7-form-control-wrap individual_name\"><input type=\"text\" name=\"individual_name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/td>\n<\/tr>\n<tr>\n<td>3<\/td>\n<td>Describe your grievance\/complaint in detail including date\/time of occurrence with necessary specifications. Attach additional sheets, if necessary, along with any documentation that will help describe and substantiate the complaint. If any witnesses are there, list names and contact details.<\/td>\n<td><span class=\"wpcf7-form-control-wrap describe\"><textarea name=\"describe\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><\/textarea><\/span><\/td>\n<\/tr>\n<\/table>\n<p>I hereby declare that the information on this form is true, correct and complete to the best of my information and belief. I understand that Grievance information may be shared with college officials in order to conduct through investigation and any misrepresentation of information may result in disciplinary action, in accordance with college disciplinary policies.<\/p>\n<\/div>\n<div class=\"col-md-12 pull-right\"> <input type=\"submit\" value=\"Submit\" class=\"wpcf7-form-control wpcf7-submit\" \/> <\/div>\n<\/div>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":[],"_links":{"self":[{"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/pages\/5"}],"collection":[{"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/comments?post=5"}],"version-history":[{"count":4,"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/pages\/5\/revisions"}],"predecessor-version":[{"id":22,"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/pages\/5\/revisions\/22"}],"wp:attachment":[{"href":"https:\/\/nadiadayurveda.org\/feedback_form\/wp-json\/wp\/v2\/media?parent=5"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}