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Student/Parent Complaint Form - Level One

Note:

Informal resolution is encouraged but does not extend any deadlines in FNG(LOCAL), except by mutual written consent. Please use this form to file a formal, initial complaint in accordance with FNG(LOCAL), regardless of the level of administrator or hearing that may be designated by the District to respond to the complaint.

This form is required to initiate any student and parent complaint, regardless of the level at which the complaint begins.

A complaint form that is incomplete in any material way may be refiled with the District upon completion if the refiling is within the designated time for filing a complaint.

Attach to this form any documents you believe will support the complaint; if unavailable when you submit this form, documents may be presented no later than the Level One conference unless you did not know the documents existed before the Level One conference. Please keep a copy of the completed form and any supporting documentation for your records.

Please fill out this form completely. All complaints will be heard in accordance with FNG(LEGAL) and (LOCAL) or any exceptions outlined therein.

A person filing a complaint regarding refusal of entry to or ejection from property under the District’s control based on Education Code 37.105 will be permitted to address the Board in person within 90 calendar days of filing the initial complaint unless the complaint is resolved before reaching the Board. [See GKA]

Name*

Answer required for "Name"

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Telephone Number*

Number Required

Campus*

Answer required for "Campus"

If you will be represented in presenting your complaint, please identify the person representing you.

Name

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Address

Answer required for "Address"

Telephone Number

Answer required for "Telephone Number"

Please describe the decision or circumstances causing your complaint.*

Answer required for "Please describe the decision or circumstances causing your complaint."

What was the date of the decision or circumstances causing your complaint?*

Answer required for "What was the date of the decision or circumstances causing your complaint?"

Please describe any efforts you have made to resolve your concerns and the responses to your efforts.*

Please include dates of communication and whom you communicated with regarding your concerns.

Answer required for "Please describe any efforts you have made to resolve your concerns and the responses to your efforts."

Please describe the outcome or remedy you seek for this complaint.*

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Upload supporting documents here.

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Choose a file or drag it here.

Confirmation Email

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