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Click ‘Get Form’ to open it in the editor.
Begin by filling in your personal information. Enter your name, grade level, and home address in the designated fields.
Provide details about the incident. In the section labeled 'Date(s) act, condition or circumstance occurred', specify when the harassment took place.
Identify the individual(s) involved by entering their names in the 'Name of harasser(s)' field.
Describe the nature of your complaint in detail. Use the space provided to explain specific events that you believe violate Federal or State laws or School District Policy.
If necessary, attach additional sheets for more information regarding your complaint and any remedies you are requesting.
Finally, sign and date the form at the bottom to complete your submission.
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