Submit a Complaint NameThis field is for validation purposes and should be left unchanged.PERSONAL DETAILS (OF COMPLAINANT):TitleFirst NameFamily NameStreet Address:Suburb:Postcode:Telephone: B/HMobile:Email: STUDENT DETAILS (IF COMPLAINT IS ABOUT A STUDENT): First Name:Family Name:Year Level:Gender(Please Tick) Male Female School Name:WHO HAVE YOU CONTACTED PREVIOUSLY ABOUT YOUR COMPLAINT? (please indicate below) Class Teacher Year Level Assistant Principal Principal LanguageCOMMUNITY LANGUAGE SCHOOL DETAILS:Campus:School Name:Principal Name:Teacher’s Name (if applicable):Telephone: B/HMobile:THIS COMPLAINT IS RELATED TO (tick relevant box/es): The administration or management staff member of the school A classroom teacher A staff member other than the child’s teacher at the school Other (please specify): UntitledHAVE YOU TAKEN THE CORRECT STEPS IN RESOLVING THE ISSUE BEFORE LODGING THIS FORM? (tick relevant box/es and provide details in spaces provided below)Class Teacher Yes No Principal Yes No Assistant Principal Yes No DETAILS OF THE MEETINGS (Attach additional information as required):Date/s of meeting/s with Class Teacher:Outcome of meeting/s:Date/s of meeting/s with Principal or Assistant Principal:Outcome of meeting/s:COMPLAINT DETAILS: Please provide an outline of your complaint. Include relevant dates / details of phone conversations or meetings / any explanations that you think are important. Attach extra pages as required (including copies of other documents relevant to your complaint). UntitledHOW DO YOU BELIEVE THIS ISSUE COULD BE RESOLVED?Applicant's SignatureMax. file size: 20 MB. Date MM slash DD slash YYYY Or, Download the file below to fill out the form offline and Send the form to the CLV Office by letter. Download Complaints Form
