Peyton Jr.-Sr. High School Complaint/Grievance/Concern Form 
This form is only pertains to students who attend Peyton Jr.-Sr. High School.  Your responses will only be viewed by Peyton Jr.-Sr. High School Administration.  Your submission will not be shared with anyone else without your expressed consent.  Thank you for letting us know about your concerns. 
Sign in to Google to save your progress. Learn more
Email *
Name
Peyton Jr.-Sr. High School 
Telephone Contact 
I wish to submit a complaint, grievance, or have a general concern against/about (Name of person, school, program, or activity) 
Please specify your complaint, grievance, or concern in more detail and the problem as you see it.   Describe the incident, the participants, the background to the incident, and any attempts you have made to solve the problem.  Be sure to note all relevant dates, times, and places. 
Is there anyone who could provide more information regarding this?  Please list name(s) and contact information.
Projected Solution-Please indicate what you think can and should be done to solve this problem or concern. Be as specific as possible 
I certify that this information is correct and to the best of my knowledge (Type in your full name)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Peyton School District.

Does this form look suspicious? Report

Google Forms