NW Islamic School
Teacher Conflict Resolution Form
NW Islamic School is committed to fostering a respectful and collaborative workplace. This form enables teaching staff to formally document concerns and seek resolution through a fair and structured process.
Teacher Information
Full Name:
Grade(s)/Subject(s) Taught:
Email Address:
example@example.com
Phone Number:
Format: (000) 000-0000.
Date of Submission:
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Month
-
Day
Year
Date
Nature of Concern
Please select the category that best describes your concern:
Interpersonal conflict (staff-to-staff)
Parent-teacher dispute
Policy or procedural concern
Workplace environment issue
Resource or support concern
Other
Please describe the concern in detail:
Individuals Involved
Name(s) of individual(s) involved:
Role/Position:
Date(s) of incident(s):
-
Month
-
Day
Year
Date
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Steps Already Taken
Please indicate any steps already taken:
Informal discussion with the individual(s)
Consulted with a colleague or mentor
Reported to administration
Other:
Summary of actions and outcomes:
Desired Outcome
Please describe the resolution you are seeking:
Confidentiality & Declaration
I understand that this form will be handled with discretion and confidentiality. I confirm that the information provided is accurate and truthful. I am committed to participating constructively in the resolution process.
Teacher Signature:
Date:
-
Month
-
Day
Year
Date
For Office Use Only
Received by:
Date Received:
-
Month
-
Day
Year
Date
Resolution Status:
Pending
In Progress
Resolved
Follow-up Date:
-
Month
-
Day
Year
Date
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NORTHWEST ISLAMIC SCHOOL
25 Years in Faith Education
CALGARY AB
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