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Pathway Academy Grievance Form
Name
Relationship to Pathway Academy (Student, Parent, Staff)
Phone
Email
Date of Incident(s)
Location of Incident9s)
Description of Grievance
Have you discussed this grievance with a teacher?
Choose an option
If yes, please provide details of the discussion.
Have you discussed this grievance with the Superintendent?
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If yes, please provide details of the discussion.
Have you discussed this grievance with the Director of Operations?
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If yes, please provide details of the discussion.
Desired Resolution
Select a date
Your Signature
Clear
By checking this box, you confirm that you acknowledge the submission of this form, that the information provided is accurate to the best of your knowledge, and that you agree to the terms outlined. Additionally, you affirm that your name, date, and submission details are recorded as part of this confirmation.
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