UNITED STATES DEP,TRT]!

18}{T OF EI}UCATION
Famil-v Educational Rights and Privacl,'Act

Instructions: Complete the fields below for Sections 1-6. Periodicaiiy save the form to avoid losing information. If you make an error, ciick
the Reset Form button at the bottom of the page to reset form fields. Click the submit button at the bottom of the page to submit your foru1 to
the Family Policy arrd Compliance Office (FPC0) as previously descritred in the iflsfructions secticn on Page 1 .

First Name Last Name Date of Birth

Makayla Kelsey 02i05t2004

Your relationship to the student whose educatinn reeords are the sutrjeet of this complaint. (If an aftorney or atlvoeafe. please note that
FPCO 'nill rrot diseuss the cornplaint rvith 3'ou without the prior comsent of the parent or eligibte student who rnaintairts the rights under
FERPA.}

O fur"n, or Legai Guardian O t*tt O Oan*r (ex. Attorney/atlt,t)cqte an behol{oJ the pttrent or eligible sutclent)

First Name Last Name

Chamelle Ketrs

StreetAddress Phone Number

2725 Hikone Dr 734-680-0894

Email
Cit). State zip Check ifFPCO moy use thk email address to cantflc! yalt

Ann Arbor MI l48roq I

Name and title ofthe school district superintendentn the president ofthe collegeluniversity, or st*te educational &g€n€y (SEA) official
(if allegiug denial to inspect and review education records mafutained try fhe SEA) or the appropriate oflicial of a thlrd party"

Name of edue ational agency and school oflicial you contacted in an attempt to resolve fhis matter Phone Number

oneer Hish School arld T Lor*'der, II 34-994-212A

MailingAddress Dates Attended

601 West Stadium BIvd 9l4ll8-N*w

City State zip Date of Aleeed Violation

Ann Arbor Mi t48104 i t1l/07,,:0le

t-1110712S19
Namt and title of school official t(x, schoot rlislricr ruBerinlen0silt. rne preridecil {,r{nr il$tlEg?iurirersit-y! 0r siatt cducatiunal agene) (S[Aj ofll{;ial {il'Btlegieg de{ifll t0 }nrptsc{ an{
reriew cdncation rerords maintained h5 the SE4) or thc appropriate olficial of a third ptrfl')

Tracey Lowder, II, Principal

ED-EMVC.002"0Exp. (XX/)OUICCIO ED 162; SORNCitationS43010? (1845-021
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\ilhat is the nature of the alleged FERPA violation? Please provide clear, succinet responses addressing all of the information
requested in the headfug{s} that pert*in to your complaint

Ifyou have been denied aecess to your, or your child's, education record(s); (1) list the education record(s) you requested from
the educational agency or instifttion; (2) indicate whether the educational agency or institution maintains the requested ed[catior
record(s) atrd, if so, how the education record{s) is maintained {if known} and the period of tinne such record(s) is retained (if
known); (3) provide the date{s) and means by which you requested access to the education record(s}; {4} indieate the name and
position of the offici*I(s) to whom you rnade the request for aceess to the education record(s); and, (5) describe any response that
you received to your requ€st or any action(s) taken by the educational ag€ncy or institution iu response to your requssL

If you have been denled the opportunity to amend your, or your child's education record{s}: (1} describe the education record(s) you
sought to amend; (2) the information in the education record(s) thatyou wanted amended and the specilic correction thatyou requested
to such information; (3) the reason you believe that the information in the edueation record(s) is rrisleading inaccurately recorded, or an
invasion ofyour, or your child's right to privacy; (4) the date you requested to amend the education record(s); (5) the name and title of
the schsol offieial to whom you made the request to amend your, or your child's education record{s}; (O any response that you received to
your request or any action(r) taken by the educational agercy or institution in response to your requestl and, (7) the result of any hearing
held by the educational agency or institution on the matter"

-gD-EMVC.0{i2.OExp. (X,X-VXXIC() ED I 62; SORNCitaiim64 30107 (1 8-05-021

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 If your, or your child's, education record{s} or personally identifiable information contained in such education record(s}was improperly
disclosed without your prior, written consent indicate specifically: (l) what education record(s) and/or personally identiliable
information was disclosed and the date of such disclosure (if known); (2) whether the information disclosed was recorded in the student's
I education recordsl (3) the narne and titte, or job function, of the school oflicial who made the disclosure; (4) the individual to whom the
- J disclosure was made and refu1i6p5hip, if any, to the educational agency or institution, and to the student; {5) the circurnstances under
whlch the disclosure was made; (6) how and when {date) you became aware of the disclosure; and, (} a description of any
communication b€tween you and the disclosing indMdual or entity, as applicable, regardiug the disclosure.

or about November 7 or 8" 2*lg, Ms. Michele Macke, a math teacher at Pioneer l{igh School in Ann
Arbr:r, N{ichigan. imprcperi,v disciosed Makayla Kelsey's grades to the students in irer second hour math class.
Ms. Macke did so without the pricr, written coflsent of fulakayia's rnother, Clhanneile Kelsey" Ms" Macke prit
Makayla's grades onto a projecfol screen and shared them r,r,ith the rest of the class on a day where htlakayia
was absent frorn class. in the context eif displaying the grades, Ms. Maske announced that she had aot seen
Makaytra all rveek and that this is wiry she was failing ail of her classes"

day, another student, Kassandra Gardner, sf;nt all image of the graeies througir a mobile app, Snapchat, tr:
Maka-vla tc show her what the teacher had done. Unforfunately, SnapChat autcmatically erased the image
from ttrre phcne" Ilut the flext day, another student from the ciass, Ranyah E*nrl, also told N{akayla about the
incident. Later that day, My',ah Tinstrey, another elassmate of iVlakayia's. texted Makayla atrr:ut the incident"

ln addition to being a rnath teacher at Pioneer High School, Ms. Macke is also the fuIath Department Chair.
fter the incident, Makayla's mother. Charmelle, eniailed Mr. Tracey Low'der, II, the principal of Pioneer
igh School, to infirrm him r:f the problem with h{s. Macke. That email \4ras sent to the administration on
r 19,2019.

Describe auy corespondencg such as newspaper articlee, website postingg e-mail or letter exehanges, that substantiates the information
specifically required ln Sedion 4 above. You may also attach copies of those relevant documents that supporf your allegations. Please note
that we will not aceept the submission of audio or yideo {iles, CDII}VDg, or tlruub drivs. AIso, the submission of nonessential voluminous, or
nonrespcnsive information may, among otler ttings, delay the processing of your complaint and could result ia tle digmissal and return of
your eomplaint"

lie Ketrse3,'sent an email referencing the FERFA violation to the school principatr, fulr. Tracey Lorvder. II. on
December 19,2A19. Please find a copy attached.

A release of inforrnation to contact Charmelle Kelsey's attorneys at the Pediakic Advocacy Clinic is also attached.

ED-EMvC.002.0Exp. (XX/)C{/XXXI1 ED 162; SORNCitation6430107(1&05-021

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I certify underpenaltyof perJurythat the foregoingis true and correct

Signature:

W
Pri':act, Act Statemett. Tht L)epar-trlent is authorized to solicit the i
S- r-ao

requested information on this Form may include, among other things, that your complaint is dismissed or retumed to you for additional clarification.

directly to: Family Policy Compliance Office, U.S. Department of Educatioa,400 Maryland Avenue, S.W., Washingion, D.C. 20?0?-8520.

Reset Forrrr Print Fcrm : Submit Form

ED-EMVC.002.0Exp. QQ#rcilOt{x) ED I 62; SORNCitation64 30107 {1 8-05-02'

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