Title IX Reporting Form
When to use this form:
If any complaint of sexual harassment or assault is made, whether by or against a
student or staff; OR
Even without a "complaint," the new amendments impose an obligation on K-12 schools to investigate if they "know" regardless of whether there is a complaint:
A school has the responsibility to respond promptly and effectively. If a school knows or reasonably should know about sexual harassment or sexual violence that creates a hostile environment, the school must take immediate action to eliminate the sexual harassment or sexual violence, prevent its recurrence, and address its effects.
Even if a student/staff or his or her parent does not want to file a complaint or does not request that the school take any action on the student's behalf, if a school knows or reasonably should know about possible sexual harassment or sexual violence, it must promptly investigate to determine what occurred and then take appropriate steps to resolve the situation.
REPORTING OF TITLE IX COMPLAINT
Are making a report for a:
*
Student
Staff
Name of Person Filling out this form
*
First and Last Name
School/Department
*
Please Select
Collegiate Preparatory Elementary
High Pointe Elementary
Highlands Elementary
Lake Ridge Elementary
Plummer Elementary
Waterford Oaks Elementary
Bessie Coleman Middle School
Permenter Middle School
Cedar Hill High School
Collegiate Academy and High School
STRIVE Academy
Academics
Business Office
Child Nutrition
Police Dept
Communications
Counseling Services
Family and Community Engagement
Health Services
Human Resources
Office of Innovation
Lacy Enrollment Center
Library and Media Services
Operations
School Leadership
Special Education
Student Sevices
Superintendents Office
Technology
Transportation
Date
*
/
Month
/
Day
Year
Date
Name of Victim
*
First and Last Name
Name of Alleged Offender
*
First and Last Name
Date Incident Occurred
*
/
Month
/
Day
Year
Date
Location of Incident detailed as possible ie room number specific hallway etc
*
Please list as many details of the event as possible:
Please upload any statement or any other files that pertain to this investigation.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Preview PDF
Submit
Should be Empty: