Contact

Your Contact Information

First Name*

Last Name*

Phone Number*

Email

Student Information

Please fill out this section completely with student name and other details. ONLY use N/A if the issue does not impact your individual child or a child you are working with, for example, a building rental concern.

School

Please SelectNot ApplicableAdams ElementaryJane Addams Middle SchoolAlki ElementaryArbor Heights ElementaryDaniel Bagley ElementaryBallard High SchoolBeacon Hill International ElementaryCatharine Blaine K-8Louisa Boren STEM K-8Broadview-Thomson K-8Bryant ElementaryCascade Parent Partnership ProgramCascadia ElementaryCedar Park ElementaryThe Center School High SchoolCleveland STEM High SchoolFrantz Coe ElementaryConcord International ElementaryB.F. Day ElementaryDearborn Park International ElementaryDecatur ElementaryDenny International Middle SchoolDunlap ElementaryEagle Staff Middle SchoolEckstein Middle SchoolEmerson ElementaryFairmount Park ElementaryFranklin High SchoolGarfield High SchoolGatewood ElementaryBailey Gatzert ElementaryGenesee Hill ElementaryGraham Hill ElementaryGreen Lake ElementaryGreenwood ElementaryNathan Hale High SchoolHamilton International Middle SchoolHawthorne ElementaryJohn Hay ElementaryHighland Park ElementaryIngraham High SchoolInteragency ProgramsKimball ElementaryMartin Luther King Jr. ElementaryAki Kurose Middle SchoolLafayette ElementaryLaurelhurst ElementaryLawton ElementaryLeschi ElementaryLicton Springs K-8Lincoln High SchoolLowell ElementaryLoyal Heights ElementaryWing Luke ElementaryMadison Middle SchoolMadrona K-8Magnolia ElementaryMaple ElementaryThurgood Marshall ElementaryMcClure Middle SchoolMeany Middle SchoolMcDonald International ElementaryMcGilvra ElementaryMercer Middle SchoolMiddle College High SchoolMontlake ElementaryJohn Muir ElementaryNorth Beach ElementaryNorthgate ElementaryNova High SchoolOlympic Hills ElementaryOlympic View ElementaryOrca K-8Pathfinder K-8Queen Anne ElementaryRainier Beach High SchoolRainier View ElementaryJohn Rogers ElementaryRoosevelt High SchoolRoxhill ElementarySacajawea ElementarySalmon Bay K-8Sand Point ElementarySanislo ElementaryChief Sealth High SchoolSeattle World SchoolSkills CenterSouth Lake High SchoolSouth Shore PreK-8John Stanford International ElementaryStevens ElementaryThornton Creek ElementaryTOPS K-8Van Asselt ElementaryView Ridge ElementaryViewlands ElementaryWashington Middle SchoolWedgwood ElementaryWest Seattle ElementaryWest Seattle High SchoolWest Woodland ElementaryWhitman Middle SchoolWhittier ElementaryHazel Wolf K-8

Student name or student ID*

Grade*

Please SelectNot ApplicablePreschoolKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th

Gender*

Please SelectNot ApplicableFemaleMaleOtherI prefer not to answer

Ethnicity (How do you identify?) *

Please SelectNot ApplicableAmerican Indian, Alaska NativeAsian/Asian AmericanAfrican AmericanAfrican/BlackEuropean American/WhiteHispanic/LatinoOtherI prefer not to answer

How are you related to the student?*

Parent or guardian  Self  Other  Not Applicable

If you selected other, please describe your relationship to the student.

Your Question or Concern

Please select the option that best describes who your issue is with *

 Admission/Enrollment/Transfer
 Advanced Learning
 Athletics
 Nutrition Services
 School Staff or Administration
 Special Education Services
 SPS or School Building/Facilities
 Summer School Program
 Technology Services
 Transportation
 Other
If you selected other, please specify.

Please select the “category type” that best describes your main issue for reaching out *

 Academics
 Accommodations (504 or IEP)
 Attendance
 Bullying
 Class Room
 Competency or Leadership
 Customer Service (Response time, Staff Professionalism, Follow up, etc.)
 Discrimination, Unfair Treatment or Equity issue
 Facility or Grounds Issue (SPS or School)
 Graduation
 Late or No show
 Policy or Process
 Safety
 Student Discipline
 School (or District) and Family Collaboration/Partnership
 Test Score/Grade/Assessment
 Other
If you selected other, please specify.

Have you talked to the school principal or program/department manager regarding your concern? *
Yes
No

Who have you talked to directly about your concern? Please specify name and title of the staff member you spoke with.

Briefly describe your main concern or question.*

Ideally, how would you like to see this resolved?*

By checking the box below, I affirm that I am submitting this information in good faith and that I am reaching out for assistance with getting an answer to my question or concern. I give permission for the information I provided to be shared with other Seattle Public Schools employees who could potentially assist with answering my question or resolving my concern. *

Yes  No  Not at this time

If you selected "no" or “not at this time,” please explain below.

(Please keep in mind that if you say no the potential of getting your question answered or problem resolved in a timely manner or at all is limited.)

Referral

How did you hear about the Seattle Public Schools Ombudsperson or who referred you to the ombudsperson?*