Educator preparation unit
About the Grievance/Appeal Process
Form
Formal Appeal/Grievance Form
Name
*
First
Last
Email
*
Phone Number
*
In what program, within the Educator Preparation Unit, are you currently enrolled? (Choose from the dropdown menu.) *
*
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Clear Administrative Services Credential
Adult Education
Career Technical Education
Supervision and Coordination
General Education Induction Program
District Intern Program
Special Education Induction Program
Autism Added Authorization Program
Early Childhood Added Authorization Program
Approximately when did you start the program? *
*
When is your anticipated date of completion?
*
Have you attempted to solve this issue through an "informal" process prior to completing this form? (Choose from the dropdown menu.) *
*
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Yes
No
Briefly describe the event or circumstance about which you wish to file a complaint or appeal. *
*
If you answered "Yes" to the question above, please describe briefly what you have done informally to address your concern.
*
Briefly describe the remedy you are seeking. *
*
Submit
About the Grievance/Appeal Process
Form