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Sexual Harassment Complaint Form
Fremont Unified School District: Any student who feels that they are being sexually harassed should immediately contact: Principal, AP, Counselor, Psychologist, Nurse or any Teacher/Staff.
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Your Name (complainant)
Reports may be made anonymously, but formal disciplinary action may not be based solely on an anonymous report.
Your answer
How to contact you (email/phone)
Your answer
School or location of incident
*
Your answer
Date and time of incident
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Your answer
Names of person/s your complaint is about (respondent)
*
Your answer
Description of the incident
*
Your answer
Other details
Did you report this already? to whom? Are you reporting this for someone else? What is your relationship to that person? any witnesses?
Your answer
BP/AR 5114.10 - Confidentiality: It is essential that the Principal ensure confidentiality throughout the investigation of allegations of sexual harassment. The actual facts of the complaint and the sensitive nature of specific allegations may require special efforts to maintain confidentiality. The Principal shall inform all parties of a sexual harassment investigation, including witnesses, not to discuss the matter with others and to refrain from any contact including personal, electronic, telephone or written contact regarding this issue.
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