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DGBA - Employee Complaint Form

Please complete the form below. Required fields marked with an asterisk *

Any employee who wishes to file a complaint must complete this form and submit it in accordance with the process described in TSD Board Policy DGBA.

1. Contact Information

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Email Address

Answer required for "Email Address"

Telephone or VP*

Number Required

Position/Department*

Answer required for "Position/Department"

2. What happened?*

Please describe the decision, action, or situation that caused your concern or complaint.

Answer required for "2. What happened?"

3. When did it happen?*

Please provide the date of the discussion, decision, or situation that caused your concern. (If you do not know the exact date, provide an approximate date.)

Answer required for "3. When did it happen?"

4. What have you done to try to resolve this?*

Please describe any steps you have taken to address the issue and how the other person(s) responded.

Answer required for "4. What have you done to try to resolve this?"

5. What outcome are you requesting?*

Please describe what action or resolution you would like to see.

Answer required for "5. What outcome are you requesting?"

Please attach any supporting documents

Answer required for "Please attach any supporting documents"

Choose a file or drag it here.

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"