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Level 1 – Initial Complaint

ARGYLE ISD

STUDENT/PARENT COMPLAINT FORM – LEVEL ONE

To file a formal complaint, please fill out this form completely and submit it by hand delivery, fax,

or U.S. mail to the appropriate administrator within the time established in FNG(LOCAL). All

complaints will be heard in accordance with FNG (LEGAL) and (LOCAL) or any exceptions

outlined therein.

1. Name ________________________________________________________________

2. Address _____________________________________________________________

Telephone number (___)_________________________________________________

3. Campus ______________________________________________________________

4. If you will be represented in voicing your complaint, please identify the person representing

you.

Name _______________________________________________________________

Address _____________________________________________________________

Telephone number (___)_________________________________________________

5. Please describe the decision or circumstances causing your complaint (give specific factual

details).

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

6. What was the date of the decision or circumstances causing your complaint?

___________________________________

7. Please explain how you have been harmed by this decision or circumstance.

_____________________________________________________________________

_____________________________________________________________________

8. 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? _____________________

9. Please describe the outcome or remedy you seek for this complaint.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Student or parent signature __________________________________________________

Signature of student’s or parent’s representative __________________________________

Date of filing ______________________________

Complainant, please note:

A complaint form that is incomplete in any material way may be dismissed, but may be re-filed

with all the required information if the re-filing 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 Level One conference. Please keep a

copy of the completed form and any supporting documentation for your records.

 

ARGYLE ISD

RESPONSE TO LEVEL ONE COMPLAINT

_______________________________________ (date)

_______________________________________ (name of complainant)

_______________________________________ (address of complainant)

_______________________________________

Dear _________________________:

Having considered the complaint we discussed in our Level One conference on

__________________ (date), I have decided on the following response:

[Note: When preparing the letter, include only one of the following sentences.]

For the following reasons, I am unable to provide the remedy you seek:

_________________________________________________________________________

__________________________________________________________________________

I will take the following actions to grant the remedy you seek for your complaint:

__________________________________________________________________________

__________________________________________________________________________

Although I am unable to provide the full remedy you seek for your complaint, I will take the

following actions to provide a partial remedy:

__________________________________________________________________________

__________________________________________________________________________

_______________________________________ (signature of principal or other appropriate

administrator)

Complainant, please note:

To appeal this response, you must file a written notice of appeal with the appropriate administrator

within the time limits set in FNG(LOCAL). The necessary forms are available at the Principal’s

or Superintendent’s office during regular business hours.