GKA(EXHIBIT) - COMMUNITY RELATIONS: CONDUCT ON SCHOOL PREMISES

NOTICE OF APPEAL OF SUPERINTENDENT'S

DECISION NOT TO WITHDRAW OR MODIFY CRIMINAL TRESPASS NOTIFICATION

Please fill out this form completely and submit it by fax or U.S. Mail to the Superintendent's office. You may also hand deliver this form if the Criminal Trespass Notification does not prohibit you from entering the District to access the Superintendent's office. You may also seek a temporary authorization from the EISD Police Department or the Superintendent or designee to enter District property to file this form; however, if granted, the temporary authorization must be in writing; must contain the purpose, date, and time for your entry on District property; and must be in your possession at all times while on District property. The Superintendent's contact information is as follows:

(210) 444-7596 – Office

(210) 444-4602 – FAX

Address: Superintendent

5358 W. Commerce Street

San Antonio, TX 78237

A Notice of Appeal must reach the Superintendent's office not later than the tenth day following your receipt of an adverse decision or delivery of an adverse decision to your address, whichever is earlier. If you mail a Notice of Appeal, it must be post marked on or before the tenth day of receipt or delivery to your address of the adverse decision.

Please provide the following information:

Name:

Mailing address:

Telephone number:

E-Mail address:

If you will be represented in voicing your complaint, please identify the person representing you.

Name:

Mailing address:

Telephone number:

E-Mail address:

Provide a copy of the front and back of the Criminal Trespass Notification that you re- quested be withdrawn or modified.

Provide a copy of your written request to the Superintendent that the Criminal Trespass Notification be withdrawn or modified.

Provide a copy of the Superintendent's decision that you are appealing by this Notice of Appeal.

In writing, provide your argument that you wish the Board to consider in your appeal of the Superintendent's decision:

Continue on the back of this page if more space is necessary.

Provide a copy of documentary evidence, if any, that you want the Board to consider.

What was the date of your receipt of the Superintendent's decision or the date that the Superintendent's decision was delivered to your address, whichever is earliest?

Please explain how you have been harmed by the Criminal Trespass Notification.

Please describe any efforts you made to resolve the circumstances behind the issuance of the Criminal Trespass Notification, if any.

With whom did you communicate?

On what date?

What outcome resulted in your efforts?

Your Signature:

Date Submitted:

THIS IS A GOVERNMENT RECORD. A PERSON COMMITS AN OFFENSE IF HE OR SHE KNOWINGLY MAKES A FALSE ENTRY IN A GOVERNMENT RECORD. Section 37.10, Texas Penal Code.

? Check the box to acknowledge that you have read and understand this notice.

Edgewood ISD-Bexar County

GKA(EXHIBIT)-X

LDU 2014.03

DATE ISSUED: 4/28/2014