A grievance is defined as a complaint in writing presented by a student/parent to the school staff alleging one or more of the following:

A. That a rule is unfair: and/or
B. That a rule in practice unfairly discriminates against or between students and/or:
C. That school personnel used an unfair or unprofessional behavior, or procedure.

COMPLAINT - Check one blank:

Personnel closest to problem: Level 1__________________________________________________________

Date:_________________

Activities Director/Principal: Level 2___________________________________________________________

Date:_________________

Superintendent: Level 3 _____________________________________________________________________

Date:_________________

School Board: Level 4_______________________________________________________________________

Date:_________________

I, hereby file a grievance complaint

to_________________________________________________________________________________________

My grievance is based on

___________A _____________ B ____________ C _____________above.
(More than one blank may be checked.)

Specifically, my grievance is that

____________________________________ Student's Signature and/or Parent Signature

The student may be represented at the conference by an adult, but the student must be present to elaborate on his/her grievance at the given time and place of the conference. Failure to appear at the appointed time and place effectively waives the student's right to the conference provided by the school, unless extenuating circumstances make it impossible for the student to appear.