Equity Complaint Form

Equity Complaint Form

First name:  Last Name: 



City:  Zip Code:  Phone: 

What do you believe was the reason for the discriminatory or harassing treatment?

 Race or Color
 National Origin

Check one that Applies:

School:  Grade: 

School/Department:  Position: 

Have you filied this compliant with any other agency?

 Yes (If yes, Name of agency and date filed)
Name:  Date: 

Explain the dicriminatory or harassing act that occured. If the complaint involves a policy, explain how and why it discriminates. A short statement in your own words is sufficent, however, you may email more information and documents if necessary to AndrewSB@leeschools.net

By typing your name in the "Full Name" field:
"I swear or affirm that I have read the above complaint and that it is true to the best of my knowledge and belief."

Full Name:  Date:

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