Beaumont ISD - Employee Complaint Level Two Appeal Notice
To appeal a Level One decision, or the lack of a timely response after a Level One confer-ence, please fill out this form completely and submit it by hand delivery, electronic communi-cation, or U.S. mail to the Superintendent's Office within the time established in DGBA(LO-CAL). Appeals will be heard in accordance with DGBA(LEGAL) and (LOCAL) or any exceptions outlined therein.
Name:
*
Address:
*
Telephone number:
*
Email address:
*
example@example.com
Campus/Department:
*
If you will be represented in presenting your appeal, please identify the person representing you. If the person representing you will participate by telephone conference call, please check the box below. The District will inform you if the equipment necessary for telephone representation is unavailable.
Representation will be by telephone conference call.
Please note:
You must designate a representative who will be participating in person or by telephone with an advance notice of at least three days, or the District may reschedule the conference or hearing to a later date.
Name:
Address:
Telephone number:
Email address:
example@example.com
Who held the Level One conference?
*
Date of conference:
*
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Month
-
Day
Year
Date
Date you received a response to the Level One conference:
*
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Month
-
Day
Year
Date
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Please explain specifically how you disagree with the outcome at Level One.
*
Attach a copy of the Level One response being appealed, if applicable.
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Employee signature:
*
Signature of employee's representative:
Date of filing:
*
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Month
-
Day
Year
Date
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