CONTROLLED UNCLASSIFIED INFORMATION (CUI)
 
DD Form 2961, JAN 2024
OMB No. 0704-0501 RCS: DD-P&R(AR)2536
OMB Control Number: 2900-0797 Expiration Date: 12/31/2018

1 Education Benefits & Issue

AUTHORITY: E.O. 13607, Establishing Principles of Excellence for Educational Institutions Serving Service Members, Veterans, Spouses, and Other Family Members; and DoD Instruction 1322.25, Voluntary Education Programs.

PURPOSE: To provide Uniformed Service Members, spouses, and other family members the opportunity to file formal complaints when educational institutions fail to follow the Principles of Excellence outlined in E.O. 13607 and DoD Instruction 1322.25 DoD Voluntary Education Partnership MOU.

ROUTINE USE(S): To the Federal Trade Commission Consumer Sentinel Network for access by the Departments of Veterans Affairs, Education, Justice, and the Consumer Financial Protection Bureau for compliance with Executive Order 13607 and potential enforcement efforts. Information may be shared with schools listed in a complaint to aid in the resolution of a case. Applicable Routine Use(s) are: Law Enforcement Routine Use, Congressional Inquiries Disclosure Routine Use, Disclosure When Requesting Information Routine Use, Disclosure of Requested Information Routine Use, Disclosure to the Department of Justice for Litigation Routine Use, Disclosure of Information to the National Archives and Records Administration Routine Use, and Data Breach Remediation Purposes Routine Use.

For a complete list of routine uses, please see the Privacy Act System of Records Notice DPR 44 DoD, DoD Postsecondary Education Complaint System (PECS), found at https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Noties/OSDJS-Article-List/

DISCLOSURE: Voluntary. However, failure to provide the information requested may result in a delay in processing your complaint or the inability of Federal agencies to address your complaint.


Veterans Benefits
You have indicated that you were separated from the military and solely receiving Veterans benefits at the time you experienced your issue. This session will end in approximately 10 seconds and you will be automatically redirected to https://www.va.gov/education/submit-school-feedback.
Education Benefits Currently Using
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Military Tuition Assistance (Title 10)
Other
GI Bill
Describe Your Issue
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Providing optional data will assist in researching your complaint.
Complaint Information


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School Information
Name *





Education Center Information




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Filing Information

Due to privacy concerns only the person receiving Federal military educational benefits from the Department of Defense can submit a complaint. Currently we are not accepting complaints submitted on behalf of someone else.
Complainant Information




Your Contact Information





Telephone (include area code)





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Summary
Please review your complaint before submitting. Use the back button at the bottom of the page to make any necessary corrections.

Education Benefits & Issue

Education Benefits Currently Using
Describe Your Issue

Complaint

Describe what happened so we can better understand the issue. Please state what steps you have taken to first resolve this issue yourself. If you are submitting on behalf of someone else and would like this complaint resolved, please provide the name of the person who experienced the issue.
What do you think would be a fair resolution to your issue?

Education

School

Level of Study
Out-Of-Pocket Tuition
Government Tuition Credit
Education Center

Complainant & Contact

Filed on Behalf of
Service Affiliation
Service Status
MyCAA Student
Branch
Pay Grade
Age

Pay Grade / Salutation
Name
Address
Telephone
Email



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