402.05E1 Grievance Forms

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Friday, August 11, 2023

BANNER COUNTY SCHOOL DISTRICT NO. 1 

GRIEVANCE FORM A 

FORMAL GRIEVANCE PRESENTATION '

(Level II - Step One) 

(To be completed by aggrieved person no later than fifteen (15) school days after stating the grievance in informal procedure) 

AGGRIEVED DATE OF PERSON _____________________________ 

PRESENTATION __________________ 

HOME ADDRESS OFAGGRIEVED PERSON ___________________________________________________________________ 

SCHOOL ___________________________________________________________________ 

SCHOOL PRINCIPAL OR IMMEDIATE SUPERVISOR _______________________________________ 

EMPLOYEES: Certified or Non-Certified _________________________________________ 

STUDENTS: ________________________________________________________________ 

STATEMENT OF GRIEVANCE: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 

ACTION REQUESTED: ______________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 

Reviewed ______________ 

Revised ________________  

BANNER COUNTY SCHOOL DISTRICT NO. 1 

GRIEVANCE FORM B DECISION OF SCHOOL PRINCIPAL OR IMMEDIATE SUPERVISOR 

(Level II - STEP ONE) 

(To be completed by school principal or immediate supervisor, within three (3) school days of formal grievance presentation.) 

AGGRIEVED PERSON _________________________________________________________________ 

DATE OF PRESENTATION _________________________________________________ 

SCHOOL _________________________________ 

SCHOOL PRINCIPAL OR IMMEDIATE SUPERVISOR ___________________________________________

DECISION OF SCHOOL PRINCIPAL OR IMMEDIATE SUPERVISOR AND REASONS THEREFOR: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 

DATE OF DECISION _________________ ________________________________ 

Signature 

AGGRIEVED PERSON'S RESPONSE: (to be completed by aggrieved not later than ten (10) days after presenting the formal grievance to the school principal or immediate supervisor.) 

_____ I accept the above decision of the school principal or immediate supervisor. 

 _____ I hereby appeal to the superintendent of schools for review of the grievance. 

DATE OF RESPONSE _________________________ 

Signature ________________________________ 

BANNER COUNTY SCHOOL DISTRICT NO. 1 

GRIEVANCE FORM C 

DECISION BY SUPERINTENDENT 

(Level II - Step Two) 

To be completed by the superintendent of schools within three (3) days after hearing the Aggrieved Person; hearing to be held within ten (10) days after receipt of appeal.) 

AGGRIEVED PERSON ___________________________________________________________________ 

DATE APPEAL RECEIVED BY SUPERINTENDENT ______________________________________________________ 

DATE HEARING HELD BY SUPERINTENDENT ______________________________________________________ 

DECISION OF SUPERINTENDENT AND REASONS THEREOF: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 

DATE OF DECISION _________________________ 

Signature_________________________________ 

AGGRIEVED PERSON'S RESPONSE: (To be completed by aggrieved not later than eighteen (18) days after presenting the grievance to the superintendent.) 

_____ I accept the above decision of the superintendent of schools. 

_____ I hereby appeal, to the board of education, for a review of this grievance. 

DATE OF RESPONSE _________________________ 

Signature File: _________________________________ BANNER COUNTY SCHOOL DISTRICT NO. 1 

GRIEVANCE FORM D 

REVIEW BY BOARD OF EDUCATION 

(Level II - Step Three) 

(To be completed by the board of education within thirty (30) school days after receipt of appeal.) 

AGGRIEVED PERSON ___________________________________________________________________ 

DATE APPEAL RECEIVED BY BOARD OF EDUCATION _________________________________________________ 

DECISION OF BOARD OF EDUCATION AND REASONS THEREFOR: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 

DATE OF DECISION OF BOARD OF EDUCATION _______________ 

Signature _________________________________ AGGRIEVED PERSON'S RESPONSE: (To be completed by aggrieved within five (5) school days of decision.) 

_____ I accept the above decision of the board of education. 

_____ I hereby request submission of this grievance to fact finding. DATE OF RESPONSE _________________________ 

Signature__________________________________