DGBA(E)-RRM[RevisionsNumberedUpdatesSD.RRM.45.docVIP

GF - E - PUBLIC COMPLAINTS The forms on the following pages are provided to assist the School in processing public complaints. Exhibit A: Complaint Form — Level One Exhibit B: Response to Level One Grievance Exhibit C: Level Two Appeal Notice Exhibit D: Response to Level Two Appeal Exhibit E: Level Three Appeal Notice Exhibit F: Board’s Response to Level Three Appeal  EXHIBIT A PUBLIC COMPLAINT FORM — LEVEL ONE To file a formal grievance, please fill out this form completely and submit it by hand delivery, email, fax, or U.S. mail to the appropriate administrator within the time established in GF. All complaints will be heard in accordance with GF and or any exceptions outlined therein. Name: Address: Telephone number: 3. If you will be represented in voicing your complaint, please identify the person representing you. If the person representing you will participate by telephone conference call, please complete the following information. Representation will be by telephone conference call. Name: Address: Telephone number: Please describe the decision or circumstances causing your complaint (give specific factual details). What was the date of the decision or circumstances causing your complaint? Please explain how you have been harmed by this decision or circumstance. Please describe any efforts you have made to resolve your complaint informally and the responses to your efforts. With whom did you communicate? On what date? Please describe the outcome or remedy you seek for this complaint. Complainant signature: Signature of Complainant’s representative: Date of filing:  Complainant, please note: A complaint form that is incomplete in any material way may be dismissed but may be refiled with all the required information if the refiling is within the designated time for filing a complaint. Attach to this form any documents you believe will support the complaint; if unavailable when you submit this form, they may be presented no later than the