Jerome Joint School District No. 261

COMMUNITY RELATIONS 4120F

Uniform Grievance Policy (Pubic Complaints) Form

Concern You Would Like Addressed

(Please keep your presentation to one sheet. Thank you.)

If the complaint pertains to sexual harassment or sexual misconduct, the concern should be remanded to the Title

IX Coordinator to address in accordance with Policy 3085.

Name: __________________________________________________________ Date ____________________________

Mailing Address: ___________________________________________________________________________________

Phone Number(s): ___________________________________________________

Subject: _______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Please identify the right guaranteed by the state or federal constitution, state or federal statute, or Board policy you

believe has been violated. If this was an instance of sexual harassment, please report the issue as described in Policy 3085 and Procedure 3085P. ________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Examples that demonstrate the problem:

Results:

Suggested Solutions:

Response Date: Person Responding ___________________________________________

Jerome Joint School District No. 261

Response to Concern

If the complaint pertains to sexual harassment or sexual misconduct, the concern should be remanded to the Title

IX Coordinator to address in accordance with Policy 3085.

Person Responding Response Date

Method used to communicate response:

Actions taken to investigate concern:

People contacted in gathering information upon which to make decision:

Findings of investigation:

Decision:

Results of communicating the decision:

Signature

Policy History:

Adopted on: 10/24/2006

Revised on: 12/15/2020

Revised on: 02/28/2023