Report Employee Discrimination and Harassment

This form should be used by employees, students, school partners/contractors and others, to report acts of discrimination and harassment where employees are the alleged victim or alleged aggressor.

NOTE: If you are reporting an incident of bullying where a student is the alleged victim, please use the Bullying and Harassment Form.

Employee Discrimination and Harassment Reporting and Investigation Form

General Information
Today's Date - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash YYYY
Name of person completing this form (First, Last) * Required
First Last
I am (choose one): * Required
I am from this school, OR this office (please provide the full name of your school or the office in which you work): * Required
Email * Required
Best phone number where we can reach you: * Required
Alleged Victim's Name (first, last) * Required
First Last
The alleged victim is:
- Me
- Not me
Alleged Victim is (choose one): * Required
Alleged Victim's School OR Office (please provide the full name of the school or office):
Alleged Victim's Race (choose one): * Required
Alleged Victim's Gender (choose one) * Required
Accused Person's Name (First, Last)
First Last
Accused Person is:
Accused Person's School/Office (please write "Don't know" if you're not sure):
Accused Person's Race:
Accused Person's Gender:
What is the relationship of the alleged victim to the accused person? Is the alleged victim:
- A supervisor of the accused person?
- A colleague of the accused person?
- Someone the the accused person manages?
- I don't know
Describe the Incident
On what Date did the Incident occur? - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash YYYY
When did the Incident Occur? * Required
Where did the incident occur? * Required
Describe the incident in detail:
Witness Name(s):
Witness Name(s):
Witness Name(s):
Do you believe the incident was based on:
Do you believe the incident was based on:

Need to register your student for school, this fall?
We will be opening registration for all grades K-12, on August 17. More information coming soon!

Learn more about the District’s updated reopening plan.
View the 2020-2021 Academic Calendar.

Interested in joining our team? The District is now
hiring for Cleaners, Bus Drivers, and Teachers. Learn more and apply HERE!

Office Menu:

Search the site:

Employee Relations

Report Employee Discrimination and Harassment

Employee Discrimination and Harassment Reporting and Investigation Form

General Information

Describe the Incident

Need to register your student for school, this fall? We will be opening registration for all grades K-12, on August 17. More information coming soon!

Learn more about the District’s updated reopening plan. View the 2020-2021 Academic Calendar.

Interested in joining our team? The District is now hiring for Cleaners, Bus Drivers, and Teachers. Learn more and apply HERE!

Office Menu:

Search the site:

Employee Relations

Report Employee Discrimination and Harassment

Employee Discrimination and Harassment Reporting and Investigation Form

General Information

Describe the Incident

Need to register your student for school, this fall?
We will be opening registration for all grades K-12, on August 17. More information coming soon!

Learn more about the District’s updated reopening plan.
View the 2020-2021 Academic Calendar.

Interested in joining our team? The District is now
hiring for Cleaners, Bus Drivers, and Teachers. Learn more and apply HERE!