New Braunfels ISD
Community Complaint
Level One
Exhibit A
To file a formal complaint, please fill out this form completely and submit it by hand delivery or U.S. mail to the
appropriate administrator within the time established in GF (LOCAL). All complaints will be heard in accordance
with GF (LEGAL) and (LOCAL) or any exceptions outlined therein.
1.
Name
2.
Address
Telephone number (
)
3. 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.
Signature
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 Level One conference. Please keep a copy of the completed form and any
supporting documentation for your records.
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