EXHIBIT C 
NOTICE OF APPEAL TO THE BOARD: LEVEL THREE

This form must be filled out completely by an employee appealing a complaint decision to the Board in accordance with the District’s  policies DGBA and DGBA (LOCAL) or any exceptions outlined therein.

1. Name: _______________________________

2. Position/Campus: _______________________________

3. To whom did you last appeal? _______________________________

Date:_________________

4. If you will be represented in pursuing your complaint, please identify that individual or organization:

Name: _______________________________

Address: _____________________________

Telephone: ____________________________

 

5. Attach copy of original complaint and all complaint decisions.

Signature: ___________________ Date Submitted: __________________