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PGCPS Section 504 Central Office Review Panel Appeal Request Form
If a parent has filed a written complaint/grievance with the Prince George's County Public Schools' Section 504 Coordinator, but is not satisfied with the outcome, s/he can request an appeal through the Section 504 Central Office Review Panel. The Section 504 Central Office Review Panel is comprised of representatives from various PGCPS offices who have extensive experience working with students who have physical and/or mental disabilities. The Section 504 Central Office Review Panel will meet once a month to hear cases. The Central Office Review Panel is a faster alternative to filing an appeal with the Office for Civil Rights.
Email address *
Student Name *
Your answer
Student's Date of Birth
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DD
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YYYY
School *
Your answer
Name of Person Filing Grievance *
Your answer
Relationship to Student *
Your answer
Student Address (House Number, Street, Apt #)
Your answer
City
Your answer
Zip Code
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Daytime Phone Number
Your answer
Alternate Phone Number
Your answer
Email Address
Your answer
Please write a brief description of the problem(s) and relevant facts:
Your answer
Please write a proposed remedy or solution:
Your answer
A copy of your responses will be emailed to the address you provided.
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