Career Path Services Grievance Form

Career Path Services Grievance Form
If you believe Career Path Services or one of its employees has violated your rights and wish to file a formal grievance, please complete this form within 30 calendar days of the incident.

If you need assistance, you may make your initial grievance verbally and request that Career Path Services' staff or an advocate of your choosing help put the grievance into writing. The cost of utilizing an outside advocate is your responsibility. We will respond in writing to your grievance within five business days with a proposed timeline for investigation into your claims and resolution.
Complainant Name:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Email
example@example.com
Person Complaint is Against
Description of Incident (include date of occurrence)
Specific rule, regulation, policy, process, or procedure not properly applied (if any)
Witnesses who can support the complaint
Other facts the complainant believes pertinent
Desired remedy
Optional: Have legal proceedings involving this alleged incident been commenced before a state or local authority? If so, please include the date of commencement and name of the authority
Signature
Date

MonthDayYear
Date
Should be Empty: