S&S CISD Parental Concern Communication Form (PCCF)
*Anonymous or fictitious submittals will not be processed.
*This concern will be read publicly at the next regularly scheduled board meeting:
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1. Email *
2. Parent First and Last Name *
3. Parent Contact Phone Number *
4. Preferred contact time
Mark only one choice
 *
5. Student First and Last Name *
6. Student I.D. Number *
7. Student Grade Level *
8. Student Home Room Teacher/2nd Period Teacher *
9. Nature of Concern

Mark only one choice.
 *
Problem with Another Student 

10. Student First and Last Name 
 *
Problem with An Adult

11. Adult First and Last Name
 *
Problem with a Policy

12. Specific Policy Code 
 *
13. Describe your concern (250-word max): *
14. Steps taken to alleviate the problem prior to online submittal? 

Mark only one choice
 *
Conference with Teacher


15. Please upload supporting documentation of conference with teacher. 

Files submitted:
 *
16. What was the solution offered by teacher? *
17. Please describe the problem with the offered solution:  *
18. What outcomes have come from this meeting? *
Conference with Principal

19. Please upload supporting documentation of conference with Principal

Files submitted:
 *
20. What was the solution offered by principal? *
21. Please describe the problem with the offered solution:  *
22. What outcomes came from this meeting? *
23. Please upload supporting documentation of conference with Superintendent

Files submitted:
 *
24. What was the solution offered by Superintendent? *
25. Please describe the problem with the offered solution:  *
26. What outcomes came from this meeting?  *
27. What remedy are you seeking? *
28. Please select one option below:  

Mark only one choice.
 *
Submit
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