AC-TCA-F2: Staff or Student Sexual Harassment Appeal Form
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Is this an appeal for a staff member or student?
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Staff Member
Student
Staff Name
Parent Name
Student Name
Email Address
I spoke/met with the appropriate school administrator
Yes
No
N/A
Name of school administrator contacted
Date spoke/met with school administrator
Must contain a date in M/D/YYYY format
Choose the appropriate school:
Central Elementary
College Pathways
Cottage School
East Elementary
High School
High School Athletics
Junior High
Junior High Athletics
North Elementary
I spoke/met with the appropriate Administrator/Decision Maker
Yes
No
N/A
Name of Administrator/Decision Maker contacted
Date spoke/met with Administrator/Decision Maker
Must contain a date in M/D/YYYY format
Date of final Findings Report
Must contain a date in M/D/YYYY format
Date Conflict Occured
Must contain a date in M/D/YYYY format
Specific Description of Reason for Appeal
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Basis for Claim and Relief Sought
Do you dispute the policy?
Do you dispute the facts?
Do you dispute how the policy was applied with the facts?
Briefly explain your claim
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Briefly explain the result you are seeking
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