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Student Referral & Reporting Forms

San José City College

Student Referral & Reporting Forms


San José City College strives to provide a safe and conducive teaching, learning, and working environment for all persons.  In accordance with San José Evergreen Community College District board policies and administrative procedures along with applicable laws and regulations, students are required to abide by standards of student conduct and are eligible to receive support services from the College.  To this end, the College provides the following student referral and reporting forms:



San José City College strives to provide access to all persons to benefit and participate in academic, co-curricular and extracurricular activities, employment, or use of college district facilities.  Persons who identify or observe an accessibility concern are asked to complete and submit the Accessibility Concern form.



Basic Needs

San José City College is committed to addressing the basic needs of students to the extent possible to ensure student success.  Basic needs includes, but is not limited to, food, housing, transportation, legal support, and referrals to off-campus resources.  Students are encouraged to complete and submit this referral form.

SJCC Student Basic Needs Referral Form


Campus Property safety concerns

San José Evergreen Community College District strives to maintain a safe learning and working environment for all students, employees, and visitors using our property. If you are aware of any safety concerns, please report them using this form so that the District may investigate the concern. All concerns will be routed to the correct office and investigated within a timely matter.

Campus Property Safety Concerns Reporting Form



Students are expected to comply with the District’s standards of student conduct as defined by Board Policy 5500 and Administrative Procedure 5500.  The College has an obligation to maintain conditions under which the work of the college can go forward freely, in accordance with the highest standards of quality, institutional integrity, and freedom of expression.  In joining the academic community, students enjoy the right of freedom to learn and share responsibility in exercising that freedom.  Faculty are asked to consult with their assigned dean to receive guidance and support when addressing student disciplinary matters.

SJCC Student Discipline Reporting Form


Grievances and Complaints

Students have the right to benefit from instruction and participate in academic, co-curricular, and extracurricular activities provided or sponsored by the College.  Students are encouraged to submit a grievance or complaint if they reasonably believe a college decision or action has adversely affected their status, rights, or privileges as a student.  The grievance or complaint may be against another student or an employee of the College.

Course Grades: It is important to note that course grades are determined by the instructor of the course and the determination of the student’s grade by the instructor, in the absence of mistake, fraud, bad faith, or incompetency, shall be final.

Exemptions: The student grievance or complaint process does not apply to standards of student conduct (student disciplinary matters), sexual misconduct (including sexual discrimination, sexual harassment, or illegal discrimination), financial aid actions, and parking tickets, all of which are covered under separate board policies and administrative procedures.

Informal Resolution – Each student who has a grievance or complaint shall make a reasonable effort to resolve the matter on an informal basis prior to requesting a grievance hearing, and shall attempt to solve the problem with the person with whom the student has the grievance or complaint, that person’s immediate supervisor, or college administration.

SJCC Student Grievance & Complaint Form


Mental Health

In case of mental health emergency, please call or text 988 for suicide and crisis support.

College employees are encouraged to refer students who experience feelings, exhibit actions, or express thoughts about mental health concerns that may affect their academic or personal well-being.  Students may also self-refer for mental health services.

SJCC Student Mental Health Referral Form


Title IX

In accordance with Title IX of the Educational Amendments of 1972, “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any educational program or activity receiving Federal financial assistance.”  All college employees are mandatory reporters which requires them to report all allegations or knowledge of sexual misconduct that involves students.

Title IX/Discrimination Form


Not sure of what actions to take or what student referral or reporting form to use?  

Contact the Office of the Vice President of Student Affairs