Evaluation Appeal Form

Greenwood International School

EVALUATION APPEAL FORM

Teacher: Ms. Sarah Chen
Department: [department]
Date of Evaluation Being Appealed: 2026-09-01
Evaluator: Dr. Michael Roberts
Date of This Appeal: 2026-09-01
Appeal Deadline: 2026-09-01

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GROUNDS FOR APPEAL

Please state the grounds on which you are appealing (tick all that apply):

□ Factual inaccuracy in the evaluation record
□ Procedural irregularity in the evaluation process
□ The evaluation was discriminatory or biased
□ Relevant evidence was not considered
□ Other (please specify below)

Provide a detailed explanation of your grounds for appeal:

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SUPPORTING EVIDENCE

List any evidence you wish to submit in support of your appeal:

1. [Evidence item]
2. [Evidence item]
3. [Evidence item]

All evidence must be submitted by 2026-09-01.

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RESOLUTION REQUESTED

What outcome are you seeking from this appeal?

□ Withdrawal of the evaluation
□ Revision of specific aspects of the evaluation
□ Re-evaluation by a different evaluator
□ Other: _______________

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DECLARATION

I confirm that the information provided in this form is accurate to the best of my knowledge.

Teacher Signature: _________________    Date: _________

Received by: Dr. Robert Williams
Date Received: _________

This appeal will be acknowledged within 5 working days and a panel hearing arranged within 15 working days.