Parent concern form
This form is required to document an unresolved concern between a family and the school.
Procedure for filing the concern is outlined below.
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Email *
Parent/guardian Name *
Parent Address: *
Contact Phone Number:
  Procedure:
1. Meeting with school principal to discuss concern , outcome of the meeting is not satisfactory to parent.
2.Concerned party completes the attached form and submits it to R. Augelli (raugelli@waterbury.k12.ct.us)
3.A response will be made within 24 hours to determine next steps.
*Possible next steps:
      phone call with R. Augelli
      meeting with school personnel
      meeting with pertinent personnel
4.If a satisfactory outcome cannot be determined, a phone call/meeting with the assistant superintendent will be scheduled.

Child's name(last name) *
Child's first name *
Child' Grade
Child's current school *
What steps in the procedure have you taken? 
Check all that apply:
 *
Required
Please Select a Concern *
Describe your concern: *
What is your desired outcome? *
Office notes: FOR OFFICE USE ONLY
Submit
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