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Submit a Civil Rights Complaint Form

Name of Person filling out this complaint:

State
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Name of person discriminated against (if other than person filing).

 

If the person discriminated against is 18 or older, we will need that person's signature on this complaint form and the consent/release form before we can proceed with this complaint.

 

If the person is a minor, and you do not have the legal authority to file a complaint on the student's behalf, the signature of the child's parent, guardian, or other authorized legal representative is required. 

State
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Department/School
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Discrimination based on race, color, and national origin also includes discrimination, including harassment, because you and/or another individual are, for example, Jewish, Muslim, Arab, Hindu, or Sikh; or based on other ethnic and religious characteristics. For example, individuals who have been subjected to ethnic slurs (such as antisemitic or anti-Muslim harassment); harassed for how they look, dress, or speak in ways related to their ethnic background (such as skin color, religious attire, or language spoken); or stereotyped based on their percieved ethnic characteristics. 

Discrimination based on disability includes discrimination against individuals who have a physical or mental impairement that substantially limits a major life acticity, as well as individuals who have a record of are regarded as having a disability.

Discrimination based on age does not limit protection against discrimination to a certain age group (e.g., people over 40); however, there are a variety of exceptions to the relevant Federal law that may permit age to be taken into account. 

Retaliation refers to actions taken for the purpose of interfering with any rights under the laws enforced by OCR, or because you made a complaint, testified, or participated in any manner in an OCR proceeding.

** Discrimination based on sex includes descrimination based on sex stereotypes, pregnancy, or related conditions, sexual orienation, and gender identity, as well as rules about parental, family, or marital status that treat people differently based on sex and should be filed under the Title IX complaint process.**

Please indicate the basis of your complaint:
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