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JDS Grievance Form Level One- Dean of Students
Any student, parent, and/or guardian who believes there has been an incident has the option of filing a grievance.
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Student First and Last Name
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Your answer
Parent/Guardian First and Last Name
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Your answer
Parent/Guardian Email
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Your answer
Date of Incident
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MM
/
DD
/
YYYY
Fully describe the incident that wish to file a grievance against. Include the specific incident or activity that is occuring or has occurred, the individuals involved, dates, times, locations, etc.
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Your answer
Identify any attempts you have made to discuss or resolve the issue with staff, include dates of discussions, and results of those discussions
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Your answer
Please provide your suggestions about how this issue could be resolved.
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Your answer
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