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Title IX Complaint form
Complainants who experience any type of sexual harassment or violence are encouraged to seek help identified in the Title IX policy. Any person may report Title IX Prohibited Conduct. To make an initial report of Title IX Prohibited Conduct, please fill out this form.
* Indicates required question
Email
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Your email
Name of Complainant
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Your answer
Complainant's role: (student, parent, faculty, staff, visitor, other (describe.)
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Your answer
Name of the person who exhibited Prohibited conduct. (Respondent)
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Your answer
Respondent's role within the school (teacher, administrator, student, parent.)
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Your answer
Date of incident
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MM
/
DD
/
YYYY
Location of incident
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Your answer
Time of incident
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Time
:
AM
PM
Nature of the conduct.
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Your answer
Date of previous report/incident (if any.)
MM
/
DD
/
YYYY
To whom any previous reports were made (if any.)
Your answer
If you wish, please describe any corrective action you are seeking.
Your answer
Submit
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