Confidential Survey-Rochester Area School District Residents 

To be submitted only to John A. Havey, Esq.
Special Counsel to the Rochester Area School District
Authorized by the Board of School Directors

Request for information and/or opinions regarding the actions, conduct and performance of Carolyn Wilkovich and/or any other person with administrative responsibilities involving the students, parents, employees, building and grounds or any other related matter affecting the Rochester Area School District.

Please submit your response to the attention of John A. Havey, in a sealed envelope, and deliver it to the Superintendent’s Office or by email: esquire247@verizon.net
 

Submitted by: 
Submitted on: 

Potential Areas of Concern:


Occurred in the past:



Ongoing and current incidents or activities:




Possible future consequences or impact: 



Incidents of a questionable nature of which I (We) have firsthand knowledge:

When did the event(s) occur?	


Incidents of concern which I have heard about through others:


List of any documents, letters, or electronic communications available for review:


Any other matters not covered above:


Contact information:  Please indicate if you will agree to a personal interview, and if so, the best method of contacting you to arrange for a convenient time and place.
	

Email address:	
Phone numbers: