STUDENT FEEDBACK

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First Name

Last Name

School Email

Grade

I am having a problem

with coursework

with a staff member

with a bully

with a personal matter

Explain your issus as much as you can.

How do you believe the issue can be resolved? It's okay to be unsure.

I am requsting a(n)...

email from Mrs. Shakara

private meeting with Mrs. Shakara

Anything else you would like to add?

Thanks, keep and eye on your email for followup.