STUDENT/PARENT COMPLAINT FORM
Schools are very important facilities. They make sure to shape children into huge successes by giving them the proper education they deserve. However, there may be problems within schools that can hinder the educational progress of the students. The person who experienced the problem should normally fill in this form. If you are making a complaint on behalf of someone else please fill in Section B also.
Email address *
What was their response? *
Your answer
Type of complaint *
Does student have an IEP?
Do we have your permission to advocate/speak to District Representatives (including Superintendent, Principal, Teachers etc.) on your behalf?
What is your relationship to the complainant? *
Your answer
Who did you report this incident to on campus? *
Your answer
Has this type of incident occurred before on campus? *
Have you complained to anyone on campus about this issue? If so, who? *
Your answer
If yes, what is your name? *
Your answer
What do you think should be done to fix this problem on campus? *
Your answer
Contact number *
Your answer
Why are you making this complaint for them? *
Your answer
Grade Level *
Approximately what time did this incident occur? *
Time
:
Full Name of Student *
Your answer
When did this incident occur? *
MM
/
DD
/
YYYY
When were you made aware of this problem? *
Your answer
What happened to make you contact us? *
Your answer
B. Are you are making the complaint for another person? *
Describe how the incident has affected you. *
Your answer
Parent/Guardian information *
Your answer
How would you prefer us to contact you? *
What is the name of the school you are complaining about? *
Your answer
A copy of your responses will be emailed to the address you provided.
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