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Complaint Form

Required

Reporter Information

Name of person making the complaintrequired
First Name
Last Name
Person making the complaint is:required

Contact Information of Person Reporting

Do you prefer to remain anonymous?required
The phone number entered could not be formatted, but will still be saved upon submission.
Are you the target (complainant) of the alleged discrimination, harassment, or retaliation?required
Sex-based Discrimination and/or Sexual Harassment
Disability-Based Discrimination (IDEA)

Details of Persons Involved in Incident(s)

Person(s) believed to be target(s) of alleged discrimination, harassment, or retaliation (please attach additional sheets/information as needed):

Person Typerequired
Person Type

Person(s) believed to be engaged in alleged discrimination, harassment, or retaliation:

Person Type
Person Type

Incident Details

Attach up to 1 file with a maximum size of 10MB
No file chosen

Witness(es) Information

Are there any witnesses to the incident(s)?required
May the school staff investigating this complaint contact these witnesses? (If so, please provide the names and contact information.)required
Person Type
Person Type

Requested Resolution/Corrective Action