Grievance Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Grievance Form

Please use this form to submit any grievances you may have. This form will only go to the HR Manager and will be kept completely confidential.
This will be used as a starting point for a conversation so please include as much information as you can.
If you have any questions or concerns please reach out to Kim Ginsberg directly either via email or in person.

If reporting more than one grievance please use different forms.

Email *

Name *

Date grievance occurred (if known). If not please make your best estimate. *

YYYY

Please describe the grievance. Include as much information as you can or feel comfortable including. Who, What, When, Where and Why are all important to answer. You can include full names (not just initials) of others who were involved or may have witnessed. *

Any other background information or witnesses

What are you looking for with a resolution? What would be your ideal outcome? *

I certify that everything noted above is accurate to the best of my knowledge. *

Yes

Digital Signature *

Today's date *

YYYY

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Marblehead Community Charter Public School. Report Abuse

Forms