Fillable G4 - V3 Appeal Web Form (Ottawa Student Transportation Authority)

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G4 - V3 Appeal Web Form (Ottawa Student Transportation Authority)

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  • 7 check-boxes
  • 11 other fields

Country of origin: CANADA
File type: PDF

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Form 17: Appeal of Decision
Date of Event:
DD/MM/YYYY
Name of Appellant:
Relation of Appellant
to Student:
Student Name:
School:
Phone No.:
Pick-up/drop-off
locations:
E-mail:
Route No.:
Home Address:
Edulog ID No.:
Reason for Appeal (mark "x"):
Breach of Policies / Procedures
Safety Concern / Health Hazard
Other - describe:
Click here to enter text.
New Information / Facts to Consider
Extenuating Circumstances
Form 17: Appeal of Decision
Brief description of appeal:
Describe your complaint and specify, if relevant, which policies and/or procedures were not followed
or what new information/facts pertinent to your initial complaint should be considered?
If relevant, describe what safety concern, health hazard or extenuating circumstances that have a
negative impact on your situation exist if your appeal is not resolved as expected.
Describe attempts at resolution: With whom did you talk? When? What was the outcome?
What resolution are you expecting?
…………………………………………………
Appellant's Signature
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signature
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G4 - V3 Appeal Web Form (Ottawa Student Transportation Authority)

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Completed 28 May 2021

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