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AC-E-2, Complaint Form

AC-E-2, Complaint Form

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The district does not permit discrimination on the basis of a person's actual or perceived characteristics such as, but not limited to, race, color, sex, sexual orientation, gender, gender identity, gender expression, religion, creed, national origin, ancestry, immigration/citizenship status, age, marital status, conditions related to pregnancy or childbirth, genetic information, mental or physical disability, need for special education services, or any other protected class in conformance with federal, state, and local law in admission or access to, or treatment and employment in, its programs or activities. A lack of English skills will not be a barrier to admission or participation. If you believe that unlawful discrimination or harassment has occurred in violation of Board Policy, please complete, sign, and submit this form to the appropriate district compliance officer.

The following person/people has/have been designated to handle inquiries regarding the nondiscrimination policies:

Title IX/Employee ADA/Section 504/EEO Compliance Officer
Director of Human Resources
800 South Taft Avenue
Loveland, Colorado 80537
(970) 613-5009

Student ADA/Section 504 Compliance Officer
Executive Director of Student Support Services
800 South Taft Avenue
Loveland, Colorado 80537
(970) 613-5092



Name of Student (if applicable):


Describe the alleged violation in specific terms. Include: (a) the specific incident or activity that is viewed as unlawful discrimination or harassment; (b) the individual(s) involved; (c) the dates, times, and locations of the incident or activity; (d) names of witness(es); and (e) why you believe the incident constitutes a violation of Board Policy AC.

Describe any relevant communication that has already occurred to address the issue. Please specify the type of communication, dates of communication, and names of individuals involved (attach additional pages if needed).

Please describe how you would propose to resolve this issue (attach additional pages if needed).

Complainant or Designee’s Signature ______________________________________

Adopted November 14, 2012
Revised July 29, 2020
Revised January 17, 2024