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Educational Complaint Form
Please utilize this form to inform LVABSE of any problems or issues that have been experienced in schools.
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone:
*
Your answer
Email
*
Your answer
Role in Education
*
Parent
Teacher
Staff
Student
Community Stakeholder
Required
School Name/Department/Affiliation
*
Your answer
District Name
*
Your answer
Date of Incident
*
MM
/
DD
/
YYYY
Please provide the name of each employee involved in your complaint, if applicable:
*
Your answer
Please briefly explain the nature of your complaint:
*
Your answer
Please specify briefly the description of any prior attempt to discuss the complaint with the appropriate party and the failure to resolve the matter:
*
Your answer
Please give a brief description of how you would like this specific complaint to be resolved:
*
Your answer
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