Code No. 102.E2
GRIEVANCE FORM FOR COMPLAINTS OF DISCRIMINATION OR NON-COMPLIANCE WITH FEDERAL OR STATE REGULATIONS REQUIRING NON-DISCRIMINATION
I, , am filing this grievance because
(Attach additional sheets if necessary)
Describe incident or occurrence as accurately as possible: (Attach additional sheets if necessary)
Signature Address:
Phone Number:
If student, name:
Grade Level:
Attendance Center:
Updated 2-18-2019