TITLE IX FORMAL COMPLAINT FORM

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Please fill out all sections of this form and click submit to ensure your complaint is filed. 

Email *

Williams Unified School District complies with federal and state laws prohibiting unlawful discrimination based on race, color, national origin, sex, disability, and age in its programs and activities. Any person that believes they have been harassed or discriminated against based on his/her sex can file a report under this procedure by contacting the District's Title IX Coordinator as follows:

Kym Logan, Title IX Coordinator
Williams Unified School District #2
636 S. 7th St., Williams, AZ 86046
Phone: 928-635-4473 ext. 612
T9reports@wusd2.org

Complainant (you) Name:
*

Address:
*

Telephone: *

Alternate Telephone (optional)

Respondent Name

This is the person who the complaint is against

Describe the alleged sexual harassment in specific terms. Make sure to include:

(A) The specific incident or activity that is alleged to be in violation of Title IX

(B) The name of all individuals involved

Date of alleged sexual harassment
*

YYYY

Describe any relevant communication that has already occurred to address the issue.

Please specify the types of communication, dates of communication, and names of individuals with whom any communication has occurred.

Do you want this Complaint to be formally addressed by the District?
*

Yes

No (Please explain by checking one of the options below)

I do not want a formal investigation. I am just bringing it to the District's attention.

I do not want a formal investigation. I would like to speak to the Title IX Coordinator about my Complaint

I affirm that I have completed this form and have provided truthful information.

Type your name below

Today's Date *

YYYY

Please click submit below.

This form will then be sent to the Title IX Coordinator.

Send me a copy of my responses.

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