Code No. 102.E6
DISPOSITION OF COMPLAINT FORM
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Date:
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Date of initial complaint:
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Name of Complainant (include whether the Complainant is a student or employee): |
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Date and place of alleged incident(s): |
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Name of Respondent (include whether the Respondent is a student or employee): |
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Nature of discrimination, harassment, or bullying alleged (check all that apply):
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Race |
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Regilion |
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Color |
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Sexual Orientation |
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National Origin |
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Age |
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Sex |
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Actual or potential parental, family or marital status |
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Disability |
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Pregnancy or related conditions |
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Creed |
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Summary of Investigation: _______________________________________________________________
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I agree that all of the information on this form is accurate and true to the best of my knowledge.
Signature: _____________________________________ Date: _________________________
Adopted: 07/16/2007
Revised: 05/12/2026
Reviewed: 05/12/2026
