School Discrimination And Harassment Complaint Form printable pdf download

School Discrimination And Harassment Complaint Form

F-1 5150

Kennewick School District

Discrimination and Harassment

Complaint Form

Please print:

Name

_____________________________________________________Date__________

Address ____________________________________________________________

Telephone ____________or number where you may be contacted ______________

during the hours of ___________________________________________________

I wish to register a complaint against:

Name of person, school (give department) program activity, etc.

__________________________________________________________________

___________________________________________________________________

Specify your complaint by stating the problem as you see it. Describe the incident,

participants, background to the incident, and any attempts you have made to resolve

the problem. Please note relevant dates, times, and places.

____________________________________________________________________

O V E R

School Discrimination And Harassment Complaint Form