Evaluation Grievance Procedure - Step II |
RUTHERFORD COUNT YSCHOOLS
Evaluation Grievance Form – Step II
This form must be completed by the grievant and submitted to the Director of Schools no later than fifteen (15) days following the decision at Step I.
Name of Grievant: __________________________________________________
School: ___________________________________________________________
Name of Evaluator: _________________________________________________
Date Step I Decision Received: ____________ Evaluation Period: _______________
Basis for grievance: Identify the inaccurate data that was used or describe the procedural error that occurred as pat of your evaluation. Explain how this inaccurate data or procedural error materially affected or compromised your evaluation. ________________________________________________________________________
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________________________________________________________________________ (Attach additional sheets or documentation as needed)
Corrective Action Desired: _________________________________________________
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Signature of Grievant: _____________________________________________________
TO BE COMPLETED BY THE EVALUATOR
Date received: ____________ Grievance Disposition: Confirmed _____ Denied______
Corrective action taken: ___________________________________________________
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Signature of Director of Schools: ___________________________________________
Date grievant notified: __________________________ |
