CAPE MAY CITY ELEMENTARY SCHOOL Parent/Student Grievance Form
To file a formal complaint, please fill out this form completely and submit it by clicking the submission tab at the end of this document, OR print and drop off hand delivery, fax, e-mail or U.S. mail to the appropriate administrator within the time established per CMCBOE Policy. A complaint filed via e-mail must be copied to the Superintendent. All complaints will be processed in accordance with CMCBOE Policy.
Email address *
Parent Information (Name) *
Parent Information (Street Address) *
Parent Information (City/State) *
Parent Information (E-mail) *
Parent Information (Phone) *
Student Information (Name) *
Student Information (Grade) *
If you will be represented, please identify the person representing you and how they would be identified, (i.e. Legal Counsel, Representative, Advocate) *
Please describe the decision or circumstances causing your complaint. Please give specific details. *
What was the date of the decision or circumstance causing your complaint? *
Please explain in detail the following: How has you/your student been impacted by the decision, determination, or circumstance? *
The District policy violated, misinterpreted, or misapplied: *
What efforts have you made to resolve your complaint informally and the response to your efforts? *
With whom did you communicate? *
On what date? *
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Please describe the outcome or remedy you seek for this complaint. *
If you are making complaints or charges against any specific individuals, please identify each of those individuals by name and title. If this is a curriculum / program request please type "Student program evaluation for... [specific program]" *
A copy of your responses will be emailed to the address you provided.
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