FOR OFFICE USE ONLY

National Junior Honor Society
Joel E. Barber C-5
APPEAL FORM

WHEN YOU MUST FILE YOUR APPEAL

You must file this completed appeal form within 15 days after the date of exception, if none, the date of the decision letter or notice.

WHERE TO FILE YOUR APPEAL
WHAT YOU MUST FILE FOR YOUR APPEAL

Joel E. Barber C-5
Laclede County
16050 Highway KK
Lebanon, MO 65536

HOW TO FILE YOUR APPEAL

Follow the instructions below, and check the applicable boxes. Put your reasons for appealing on page 2 of this form – do not leave it blank. Personal appearances to present arguments to the Appeal Board are not permitted. The Appeals Board will acknowledge receipt of your appeal in writing. If you do not receive an acknowledgement within 20 days of mailing or hand delivering this form, contact the Appeals Board at (417) 532-4837, or at the address above. Keep a copy of the appeal form for your personal record and any proof of mailing your records and/or contact dates.

WHAT SHOULD BE APPEALED AND NEEDS TO BE REVIEWED? (Check applicable box.)

Denial of an application for acceptance

Denial of membership

The penalty and the decision on which it is based

If a hearing in your case is relevant with the Joel E. Barber School Board was held and you want the testimony reviewed, you must request a second order of review

Other (please clarify of page 2 of this form)

If you checked the box to appeal only the penalty, your reasons will be reviewed for a proceeding evaluation. The Appeals Board will not review the hearing testimony if your Appeal Form is late or incomplete. However, if the review is denied by regulations of the National Junior Honor Society, the appeal will be rejected.

You may send additional arguments to the Appeals Board within 30 days. If you do not have a copy of your child’s official application one will be provided.

COMPLETE PAGE 2 OF THIS FORM.

FILL IN THE INFORMATION BOXES BELOW. Please Type or Print Clearly.
Student’s Last Name First M.I. / Date of Birth (Month/Date/Year)
/ /
Date of Birth
/ / / Date of Decision
/ /
Parents Last Name First M.I. / Type of Appeal (2nd review or revocation)
Mailing Address (Number and Street) / City or Town State Zip Code

For most decisions, a verdict will be determined by the Appeals Board. All other decisions are discretionary, and the Board will notify you in writing whether it is granted or denied. No decision can be granted if you do not a give a valid reason for appealing.

TYPE OR PRINT THE REASON FOR YOUR APPEAL

Print or type your explanation of why you are appealing and your reasons for a decision. Do not leave this section blank. Attach additional pages if necessary. Read and sign the certification form at the bottom of this page.

Any requests will be given to the Appeals Board.

SIGN THIS CERTIFICATION:
I certify that the information I have given in connection with this appeal is true, to the best of my knowledge.
Sign Here ______
(Sign Name in Full - Student) (Date)
______
(Sign Name in Full - Parent) (Date)

FORMS MUST BE RETURNED TO MRS. WHITNEY WRAST, NJHS ADVISOR