To Whom It May Concern, 

This letter is to request immediately that my son/daughter,_______, be afforded all the protections under state and federal law to protect him from physical or emotional harassment, discrimination, retaliation, or verbal abuse.  As schools legally acts in behalf of the parent while in their care, it is my understanding that he/she has a right to learn in a safe and harm-free educational environment. 

It is also my understanding that school personnel have a duty to facilitate his protection and fully investigate all allegations he reports.  I am now requesting that you protect my child from the various forms of abuse he has suffered at your school. 

Because my child is a minor, he/she has been informed that he/she is not to discuss any allegations of such abuse without myself/parent/legal guardian present during these discussions. I expect to be immediately called to attend to these discussions if my child makes a complaint.

I am requesting that this protection begin immediately. I will assume you are taking the appropriate action from this date forward. If I am incorrect, I request you immediately notify me, and my advocate at the following address: 
 

          Advocate/Parent name 
          address 
          city, state, zip 
          phone # 
 

Sincerely, 

Parent's name 
 

Parent Signature: ________________________________
Date: _____________________________