Complaint Intake Form

Name: Mitchell Tech
Address: 1800 East Spruce Street, Mitchell, SD, 57301, US
Telephone: 1.800.684.1969

Please complete all blanks in the complaint intake form.

Person submitting form, if different than complainant:

First Name:

Last Name:

Email Address:

Telephone:

If you are a current Mitchell Tech student, please provide your student ID:

Choose the role that best describes you:

Date of Complaint/Incident:

Please provide a brief explanation of your complaint: